15 General introduction exercise. This study provides insights into the app’s benefits from the users’ perspective and how it impacts their adherence to exercise recommendations. Chapter 4 describes the protocol for a cluster randomized controlled trial, investigating the effectiveness and cost-effectiveness of stratified blended physiotherapy in patients with LBP. The intervention combines face-to-face physiotherapy with an app to improve self-management skills and adherence to exercise recommendations. Chapter 5 presents the results of a cluster randomized controlled trial investigating the 3-month effectiveness and cost-effectiveness of e-Exercise LBP (a stratified blended physiotherapy intervention) compared to usual care physiotherapy in patients with LBP. In Chapter 6, the study uses a longitudinal analysis to identify distinct trajectories of adherence to HBE recommendations among people with LBP. Additionally, the study aims to identify whether baseline characteristics can predict trajectories of adherence to inform better patient management. Chapter 7 explores the association between adherence to HBE recommendations and recovery from LBP. This study examines whether high adherence rates improve clinical outcomes in patients LBP. Lastly, Chapter 8 presents the discussion on the findings and methodological considerations of chapters 2 through 7. Furthermore, the implications for clinical practice, society, education, and future research are described. The thesis ends with a summary in English and in Dutch. 1
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