Introduction:
Exercise therapy plays a pivotal role in the self-management of individuals coping with chronic low back pain (LBP). This study aimed to investigate the association between motivation for home exercise and health-related quality of life (QOL) in patients with chronic LBP in the general Japanese population.
Methods:
A comprehensive Internet survey encompassing 95,523 participants drawn from the general public throughout Japan was conducted to identify patients with chronic LBP (characterized by a numerical rating scale ≥ 3, symptoms lasting ≥ 3 months) who were instructed to perform home exercise in the clinic. The Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) was used to measure the intensity of motivation for home exercise and the EuroQol-5Dimension (EQ-5D) was used to assess health-related QOL. BREQ-2 and EQ-5D were examined in a multiple regression analysis adjusted for age, sex, education, presence of family members living with the patient, presence of comorbidities (stroke, heart disease, diabetes, and dementia), and pain intensity. Furthermore, participants were surveyed on the number of types of home exercises they considered feasible.
Results:
A total of 911 patients with chronic LBP were identified (502 males and 409 females; mean age, 59 years). The BREQ-2 total score had a significantly positive effect on the EQ-5D score (β = 0.090 (95% confidence interval, 0.028-0.152), p = 0.005). In an exploratory factor analysis, introjected regulation, external regulation, and amotivation had a significantly positive effect on the EQ-5D score. Notably, patients averagely considered 3.0 (0-20, standard deviation 2.3) types of home exercises feasible.
Discussion:
Patients with chronic LBP who were more motivated to exercise at home had higher health-related QOL. However, exploratory factor analysis indicated that the actual motivation for home exercise may not be inherently spontaneous; rather, patients may be encouraged or coerced by their surroundings to perform the exercises. Additionally, this study underscores the importance of focusing on specific, limited types of exercises during patient instruction in the clinic.