{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T10:29:41Z","timestamp":1792751381748,"version":"4.5.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009713","name":"Foundation for Physical Therapy","doi-asserted-by":"publisher","award":["Magistro Family Foundation Grant"],"award-info":[{"award-number":["Magistro Family Foundation Grant"]}],"id":[{"id":"10.13039\/100009713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001442"],"award-info":[{"award-number":["UL1TR001442"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background\/Objective<\/jats:title>\n<jats:p>Exercise-based rehabilitation is a conservative management approach for individuals with low back pain. However, adherence rates for conservative management are often low and the reasons for this are not well described. The objective of this study was to evaluate predictors of adherence and patient-reported reasons for non-adherence after ceasing a supervised exercise-based rehabilitation program in individuals with low back pain.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>Retrospective observational study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data was retrospectively analyzed from 5 rehabilitation clinics utilizing a standardized exercise-based rehabilitation program. Baseline demographics, diagnosis and symptom specific features, visit number, and discontinuation profiles were quantified for 2,243 patients who underwent the program.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Forty-three percent (43%) of participants were adherent to the program, with the majority (31.7%) discontinuing treatment prior to completion due to logistic and accessibility issues. Another 13.2% discontinued prior to the prescribed duration due to clinically significant improvements in pain and\/or disability without formal discharge evaluation, whereas 8.3% did not continue due to lack of improvement. Finally, 6.0% were discharged for related and unrelated medical reasons including surgery. Individuals diagnosed with disc pathology were most likely to be adherent to the program.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Limitations<\/jats:title>\n<jats:p>This study was a retrospective chart review with missing data for some variables. Future studies with a prospective design would increase quality of evidence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The majority of individuals prescribed an in-clinic exercise-based rehabilitation program are non-adherent. Patient diagnosis was the most important predictor of adherence. For those who were not adherent, important barriers include personal issues, insufficient insurance authorization and lack of geographic accessibility.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0276326","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T18:34:56Z","timestamp":1666290896000},"page":"e0276326","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":41,"title":["Factors impacting adherence to an exercise-based physical therapy program for individuals with low back pain"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7532-6940","authenticated-orcid":true,"given":"Bahar","family":"Shahidi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2837-0762","authenticated-orcid":true,"given":"Jennifer","family":"Padwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euyhyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronghui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Northway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4846-6796","authenticated-orcid":true,"given":"Lissa","family":"Taitano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamshad","family":"Raiszadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"issue":"6","key":"pone.0276326.ref001","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1001\/jama.2013.13805","article-title":"The state of US health, 1990\u20132010: burden of diseases, injuries, and risk factors","volume":"310","author":"Collaborators UBoD","year":"2013","journal-title":"JAMA"},{"issue":"9178","key":"pone.0276326.ref002","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0140-6736(99)01312-4","article-title":"Epidemiological features of chronic low-back pain","volume":"354","author":"GB Andersson","year":"1999","journal-title":"Lancet"},{"issue":"1","key":"pone.0276326.ref003","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1053\/berh.2001.0204","article-title":"The economic burden of low back pain: a review of studies published between 1996 and 2001.","volume":"16","author":"A Maetzel","year":"2002","journal-title":"Best Pract Res Clin Rheumatol."},{"issue":"6","key":"pone.0276326.ref004","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.berh.2010.10.002","article-title":"The Epidemiology of low back pain","volume":"24","author":"D Hoy","year":"2010","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"2","key":"pone.0276326.ref005","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/00002517-199304000-00007","article-title":"Fat content of lumbar extensor muscles and low back disability: a radiographic and clinical comparison","volume":"6","author":"H Alaranta","year":"1993","journal-title":"J Spinal Disord"},{"issue":"5","key":"pone.0276326.ref006","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1589\/jpts.28.1418","article-title":"Effects of muscle extension strength exercise on trunk muscle strength and stability of patients with lumbar herniated nucleus pulposus","volume":"28","author":"K Jeon","year":"2016","journal-title":"J Phys Ther Sci"},{"issue":"3","key":"pone.0276326.ref007","first-page":"201","article-title":"The effects of back extension training on back muscle strength and spinal range of motion in young females","volume":"30","author":"Y. 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