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Abstract：
BACKGROUND: The effectiveness of physiotherapy to reduce low back pain depends on patient adherence to treatment. Facilitators and barriers to patient adherence are multifactorial and include patient and therapist-related factors. This Delphi study aimed to identify an expert consensus on aspects facilitating the adherence of patients with back pain to physiotherapy.
METHODS: International experts were invited to participate in a three-round standard Delphi survey. The survey contained 49 items (32 original and 17 suggested by experts) which were rated on 5-point Likert scales. The items were assigned to six domains. The consensus level was defined as 60%.
RESULTS: Of 38 invited experts, 15 followed the invitation and completed all three rounds. A positive consensus was reached on 62% of the 49 proposed items to facilitate adherence. The highest consensus was achieved in the domains \"Influence of biopsychosocial factors\" (89%) and \"Influence of cooperation between physiotherapists and patients\" (79%). Additional important domains were the \"Influence of competencies of physiotherapists\" (71%) and \"Interdisciplinary congruence\" (78%). \"Administration aspects\" and the \"Use of digital tools\" did not reach expert consensus.
CONCLUSIONS: Biopsychosocial factors, therapeutic skills, and patient-physiotherapist collaboration should be considered in physiotherapy practice to facilitate adherence in patients with LBP. Future studies should prospectively evaluate the effectiveness of individual or combined identified aspects for their influence on patient adherence in longitudinal study designs.
METHODS: International experts were invited to participate in a three-round standard Delphi survey. The survey contained 49 items (32 original and 17 suggested by experts) which were rated on 5-point Likert scales. The items were assigned to six domains. The consensus level was defined as 60%.
RESULTS: Of 38 invited experts, 15 followed the invitation and completed all three rounds. A positive consensus was reached on 62% of the 49 proposed items to facilitate adherence. The highest consensus was achieved in the domains \"Influence of biopsychosocial factors\" (89%) and \"Influence of cooperation between physiotherapists and patients\" (79%). Additional important domains were the \"Influence of competencies of physiotherapists\" (71%) and \"Interdisciplinary congruence\" (78%). \"Administration aspects\" and the \"Use of digital tools\" did not reach expert consensus.
CONCLUSIONS: Biopsychosocial factors, therapeutic skills, and patient-physiotherapist collaboration should be considered in physiotherapy practice to facilitate adherence in patients with LBP. Future studies should prospectively evaluate the effectiveness of individual or combined identified aspects for their influence on patient adherence in longitudinal study designs.
摘要：
背景：物理治疗减轻下腰痛的有效性取决于患者对治疗的依从性。患者依从性的促进者和障碍是多因素的，包括患者和治疗师相关的因素。这项Delphi研究旨在确定在促进背痛患者坚持物理治疗方面的专家共识。
方法：邀请国际专家参加了三轮标准德尔菲调查。调查包含49个项目（32个原始项目和17个专家建议），按5分利克特量表进行了评级。这些项目被分配到六个域。共识水平被定义为60%。
结果：在38位受邀专家中，15遵循邀请并完成了所有三轮比赛。在49个拟议项目中，有62％达成了积极共识，以促进遵守。在“生物心理社会因素的影响”（89％）和“物理治疗师与患者之间合作的影响”（79％）领域达成了最高共识。其他重要领域是“物理治疗师能力的影响”（71％）和“跨学科一致性”（78％）。“管理方面”和“使用数字工具”没有达成专家共识。
结论：生物心理社会因素，治疗技能,在物理治疗实践中,应考虑患者-物理治疗师合作,以促进LBP患者的依从性.未来的研究应前瞻性评估纵向研究设计中个体或综合识别方面对患者依从性的影响的有效性。
方法：邀请国际专家参加了三轮标准德尔菲调查。调查包含49个项目（32个原始项目和17个专家建议），按5分利克特量表进行了评级。这些项目被分配到六个域。共识水平被定义为60%。
结果：在38位受邀专家中，15遵循邀请并完成了所有三轮比赛。在49个拟议项目中，有62％达成了积极共识，以促进遵守。在“生物心理社会因素的影响”（89％）和“物理治疗师与患者之间合作的影响”（79％）领域达成了最高共识。其他重要领域是“物理治疗师能力的影响”（71％）和“跨学科一致性”（78％）。“管理方面”和“使用数字工具”没有达成专家共识。
结论：生物心理社会因素，治疗技能,在物理治疗实践中,应考虑患者-物理治疗师合作,以促进LBP患者的依从性.未来的研究应前瞻性评估纵向研究设计中个体或综合识别方面对患者依从性的影响的有效性。
