The accuracy of self-reported adherence to an activity advice

Objective. The aim of this cross-sectional observational study was to investigate whether patients referred for non-specific low back pain accurately report whether they follow home-based activity advice. Research suggests that inadequate adherence to home-based activity advice during an intervention period might diminish the effectiveness of an intervention. Insight into patient adherence to home-based activity advice is hindered by a lack of objective data. Most data consist of self-reporting and interviews. Methods. Participants were advised to complete a home-based activity for 1 week. We validated self-reporting of home-based activity with data obtained from an activity monitor worn by 51 patients who reported non-specific low back pain. The proportion of accurate self-reporting and kappa values were calculated to determine the level of accuracy of self-reporting. Results. An analysis of 357 (51 x 7) walking days found accurate participant reports on 233 days; only 22% of the participants reported accurately on all 7 consecutive days. Low kappa scores between the barrier list and the activity monitor show the poor reliability of participants' self-reporting. Conclusion. Self-reporting about the performance of advised home-based activity for the management of non-specific low back pain in a physiotherapy practice setting is rather inaccurate.