A matter of choice: Should students self-select exercise for their nonspecific chronic low back pain? A controlled study

Objectives: To explore the effect of autonomy to choose exercise-therapy (ET) for nonspecific chronic low back pain (NSCLBP) on treatment adherence and clinical outcomes. Participants: Forty-six students were recruited from Ariel University. Methods: Every two gender-and-age-matched students were allocated to either self-selected exercise group (SSE) or pre-determined exercise group (PDE). Subjects completed 4-weeks exercise and filled a training-log. Oswestry disability-index (ODI) and numerical pain-rating scores (NPRS) were measured, as well as exercise quality-performance. Results: ODI and NPRS improved in both groups, with no between-group differences. Exercise quality-performance was also similar between groups. A trend for better exercise-adherence was found in the SSE-group (75.3% vs 65.0% adherence, p = 0.08, effect size d = 0.59). Meaningful NPRS improvement was demonstrated in 54.5% of SSE-group participants compared with 33.3% in the PDE-group. Conclusions: Autonomy may serve as a factor to enhance treatment adherence and clinical outcomes of ET for NSCLBP among students.