Finding predictive factors of stabilization exercise adherence in randomized controlled trials on low back pain: an individual data Reanalysis using machine learning techniques
Objective - To identify predictors of adherence in supervised and self-administered exercise interventions for individuals with low back pain. - Design - Cohort study. - Setting - Rehabilitation. - Participants - This preplanned reanalysis within the Medicine in Spine Exercise Network included 1511...
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| Auteurs principaux: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Langue: | anglais |
| Publié: |
May 2025
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| In: |
Archives of physical medicine and rehabilitation
Year: 2025, Volume: 106, Numéro: 5, Pages: 738-749 |
| ISSN: | 1532-821X |
| DOI: | 10.1016/j.apmr.2024.12.015 |
| Accès en ligne: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.apmr.2024.12.015 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0003999324014199 
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| Notes sur l'auteur: | Ann-Christin Pfeifer, PhD, Paul Schröder-Pfeifer, PhD, Marcus Schiltenwolf, MD, Lutz Vogt, PhD, Christian Schneider, MD, Petra Platen, MD, Heidrun Beck, MD, Pia-Maria Wippert, PhD, Tilman Engel, PhD, Monique Wochatz, PhD, Frank Mayer, MD, Daniel Niederer, PhD |
| Résumé: | Objective - To identify predictors of adherence in supervised and self-administered exercise interventions for individuals with low back pain. - Design - Cohort study. - Setting - Rehabilitation. - Participants - This preplanned reanalysis within the Medicine in Spine Exercise Network included 1511 participants with low back pain (57% female, mean age 40.9 years, SD ±14 years). - Interventions - Participants underwent an initial 3-week supervised phase of sensorimotor exercises, followed by a 9-week self-administered phase. - Main Outcome Measures - Biological, psychological, and social factors potentially impacting training adherence were evaluated. During the supervised phase, adherence was tracked through a standardized training log. During the self-administered phase, adherence was monitored via a diary, with adherence calculated as the percentage of scheduled versus completed sessions. Adherence was analyzed both as an absolute percentage and as a dichotomized variable (adherent vs nonadherent, with a 70% adherence cut-off). Predictors for adherence were identified using Gradient Boosting Machines and Random Forests (R package caret). Seventy percent of the observations were used for training, whereas 30% were retained as a hold-out test-set. - Results - The average overall adherence was 64% (±31%), with 81% (±28%) adherence during the supervised phase and 58% (±39%) in the self-administered phase. The root mean square error for the test-set ranged from 36.2 (R2=0.18, self-administered phase) to 19.3 (R2=0.47, supervised phase); prediction accuracy for dichotomized models was between 64% and 83%. Predictors of low to intermediate adherence included poorer baseline postural control, decline in exercise levels, and fluctuations in pain intensity (both increases and decreases). - Conclusion - Identified predictors could aid in recognizing individuals at higher risk for nonadherence in low back pain exercise therapy settings. |
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| Description: | Gesehen am 02.06.2026 |
| Description matérielle: | Online Resource |
| ISSN: | 1532-821X |
| DOI: | 10.1016/j.apmr.2024.12.015 |