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A Cross-Sectional Study Assessing Treatment Preference of People With Chronic Low Back Pain

      Abstract

      Objective

      To assess treatment preference and attributes of 2 exercise-based treatments for people with chronic low back pain (LBP).

      Design

      Cross-sectional study.

      Setting

      Academic research setting.

      Participants

      Individuals (N=154) with chronic LBP.

      Interventions

      Not applicable.

      Main Outcome Measures

      Participants completed a treatment preference assessment (TPA) measure that described 2 treatments for chronic LBP (strength and flexibility [SF] and motor skill training [MST]). Participants rated each treatment on 4 attributes: effectiveness, acceptability/logicality, suitability/appropriateness, and convenience. An overall score for each treatment was calculated as the mean of the 4 attribute ratings. The participants indicated either (1) no treatment preference or (2) preference for SF or MST.

      Results

      One hundred four participants (67.5%) had a treatment preference; of those, 95 (91.3%) preferred SF and 9 (8.7%) preferred MST. The SF preference group rated SF higher than MST overall and on all attributes (all Ps <.01, ds ranged from .48-1.07). The MST preference group did not rate the treatments differently overall or on any of the attributes (all Ps >.05, ds ranged from .43-.66). Convenience of SF (P=.05, d=.79) and effectiveness (d=1.20), acceptability/logicality (d=1.27), and suitability/appropriateness (d=1.52) of MST (all Ps <.01) were rated differently between the 2 preference groups.

      Conclusions

      When presented with 2 treatment options, a majority of patients preferred SF over MST. Convenience was a particularly important attribute affecting preference. Assessing treatment preference and attributes prior to treatment initiation allows the clinician to identify factors that may need to be addressed to enhance adherence to, and outcomes of, treatment.

      Keywords

      List of abbreviations:

      LBP (low back pain), MODQ (modified Oswestry Low Back Pain Disability Questionnaire), MST (motor skill training), PT (physical therapy), REDCap (Research Electronic Data Capture), SF (strength and flexibility), TPA (treatment preference assessment)
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