Chronic low back pain (CLBP) is the leading cause of disability worldwide, of which 90% is “non-specific,” meaning it has no pathological cause. A number of psychosocial factors negatively affect outcomes in CLBP. Although exercise is an effective treatment for CLBP, adherence to exercise in these populations is low due to similar psychosocial factors that predict poor outcomes. Yoga has been suggested as a mind-body therapy for CLBP, however adherence to yoga in these populations has not been studied. This exploratory literature review aims to explore adherence levels to yoga when used as a therapy for CLBP.
An electronic database search was conducted for papers that researched the effects of yoga for CLBP. Articles were selected according to the eligibility criteria set, studies included must report adherence. The quality of adherence reporting was appraised and data was extracted on adherence, study design and participant characteristics.
Results: A total of 1673 participants with CLBP across twelve studies were included, of which 784 were assigned to a yoga intervention. Quality of adherence reporting varied greatly, adherence to both yoga classes and home practice was explored.
Conclusion(s): There was not enough consistency in adherence reporting to provide a conclusive answer to the main question of this review. Where there were similar measures of adherence used, the ranges varied greatly, reflecting the complex nature of adherence and therefore its reporting is complex. There is a need for clear adherence reporting in future studies.
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DRAFT With a move towards shared clinical decision making, terms like adherence may seem outdated, as it still relies on the healthcare provider setting out specific recommendations. However within this new framework of shared decision making, although a clinician may no longer be solely responsible for deciding the management, it still remains the clinician’s responsibility to provide accurate information about the efficacy of a therapeutic option. In order for the patient to make an informed decision, the healthcare professional needs to advise a patient of the benefits of a possible interventions. Therefore research must be of a high standard, and if adherence is not reported accurately in research that would greatly affect the outcome of a therapeutic trial and the information provided to the patient. In clinical practice, ways to measure adherence should be considered to evaluate the efficacy of the intervention and identify barriers to adherence.
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