Using Evidence to Increase Compliance with Therapeutic Stretching for Chronic Low Back Pain

In June 2012, a team of nurses at the Army's Landstuhl Regional Medical Center was tasked to generate an evidence-based practice recommendation for patients experiencing chronic low back pain (CLBP).

Based on 14 articles, the evidence (a) validated the use of therapeutic stretching for control of CLBP, (b) identified specific modalities to increase patient adherence, and (c) supported military relevance. The team developed a questionnaire to assess previous experience with stretching exercises and preferred learning methods. Based on the responses from 32 patients, the initial goals included an increase in patient reported compliance within 3 months and a decrease in reported pain within 6 months. Long-terms goals targeted a 90% patient compliance in daily stretching regimen and a continued decrease in pain within 1 year.

At 3 months, a 96% compliance rate was reported for patients returning for follow-up appointments; however, the average reported pain level did not decrease.

Similar clinics could benefit from methods/tools used in this project, especially where lack of compliance becomes a deterrent to quality of care.