Prentice, Caitlin Lauren Siobhan, Flavell, Carol Ann, Massy-Westropp, Nicola, and Milanese, Steven (2025) Understanding responsiveness to an exercise intervention for people with persistent low back pain and lateral abdominal muscle impairments. A mixed methods study. Physiotherapy Theory and Practice. (In Press)

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Abstract

Background: Exercise consistently demonstrates a small effect size for patients with persistent low back pain (PLBP). Determining patient characteristics that influence intervention responsiveness may improve treatment allocation and effect sizes. An exercise intervention for patients with PLBP and maladaptive changes in lateral abdominal muscle (LAM) contraction was recently trialed.

Objective: To identify factors predicting responsiveness to an exercise intervention for patients with PLBP and why. Methods: This was a secondary mixed methods analysis of results from a feasibility randomized controlled trial with 50 participants. The 12-week program included individualized motor control and graded activity exercise. Regressions were performed to understand potential associations between characteristics (demographic, condition-specific signs and symptoms, compliance with exercise, and beliefs about exercise) and outcomes (pain, function, disability, and LAM contraction).Interview transcripts were analyzed for characteristics unique to participants that responded most and least to the intervention. Data was integrated for complementarity.

Results: At baseline, females, participants with lower BMIs, decreased chronicity, fewer areas of pain, who had less previous interactions with healthcare professionals, and who were more positive about the potential for exercise to improve their pain had greater responsiveness(Adjusted R2 ranged from 0.17 to 0.66). During and after the program, increased physical activity levels was a positive predictor.

Conclusion: Responsiveness to the intervention may have been mediated by several baseline factors which may have affected participants’ engagement with the intervention and continuation with exercise post intervention. Such characteristics may assist clinicians identifying whether this may be an appropriate intervention for patients with PLBP

Item ID:	85125
Item Type:	Article (Research - C1)
ISSN:	1532-5040
Keywords:	Low back Pain, Motor Control, Exercise
Copyright Information:	© 2025 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Date Deposited:	15 Apr 2025 22:56
FoR Codes:	42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420106 Physiotherapy @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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