Exercise is a first-line treatment for chronic low back pain (CLBP), reducing pain and disability in the short term. However, exercise benefits decrease over time, with a lack of long-term exercise adherence a potential reason for this. This study aimed to synthesize the perceptions and beliefs of individuals with CLBP and identify their barriers and enablers to exercise adherence. We searched CENTRAL, Embase, CINAHL, SPORTDiscus, PubMed, PsycINFO, and Scopus databases from inception to February 28, 2023, for qualitative studies that explored the factors influencing exercise adherence for people with CLBP. A hybrid approach combining thematic synthesis with the Theoretical Domains Framework was used to analyze data. We assessed methodological quality using the Critical Appraisal Skills Programme checklist and the level of confidence of the themes generated using the Confidence in the Evidence from Reviews of Qualitative Studies. Twenty-three papers (n = 21 studies) were included (n = 677 participants). Four main themes affected exercise adherence: (1) exercise, pain, and the body, (2) psychological factors, (3) social factors, and (4) external factors. These themes contained 16 subthemes that were predominantly both barriers and enablers to exercise adherence. The individual's experiences of barriers and enablers were most appropriately represented across a spectrum, where influencing factors could be a barrier or enabler to exercise adherence, and these could be specific to pre-exercise, during-exercise, and post-exercise situations. These findings may be used to improve exercise adherence and ultimately treatment outcomes in people with CLBP.

中文翻译：

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非特异性慢性腰痛患者坚持锻炼的障碍和推动因素：定性证据的系统回顾。

运动是慢性腰痛 (CLBP) 的一线治疗方法，可在短期内减轻疼痛和残疾。然而，运动的好处会随着时间的推移而减少，缺乏长期坚持运动是造成这种情况的潜在原因。本研究旨在综合 CLBP 患者的看法和信念，并确定他们坚持锻炼的障碍和推动因素。我们检索了从建库到 2023 年 2 月 28 日的 CENTRAL、Embase、CINAHL、SPORTDiscus、PubMed、PsycINFO 和 Scopus 数据库，以寻找探索影响 CLBP 患者运动坚持的因素的定性研究。使用将主题综合与理论领域框架相结合的混合方法来分析数据。我们使用批判性评估技能计划清单评估了方法质量，并使用定性研究评论证据的置信度生成主题的置信度。纳入 23 篇论文（n = 21 项研究）（n = 677 名参与者）。影响运动坚持的四个主题：（1）运动、疼痛和身体，（2）心理因素，（3）社会因素，（4）外部因素。这些主题包含 16 个子主题，这些主题主要是坚持的障碍和推动因素。个人对障碍和促成因素的经历最恰当地代表了整个范围，其中影响因素可能是锻炼依从性的障碍或促成因素，并且这些因素可能特定于运动前、运动期间和运动后的情况。这些发现可用于提高 CLBP 患者的运动依从性并最终改善治疗结果。