Exercise adherence in trials of therapeutic exercise interventions for common musculoskeletal conditions: A scoping review.

Matthew Kenny, Tharindu Ranabahu, Patrick Vallance, Yuxin Zhang, Jacqueline Gurr, Kenneth Färnqvist, Sangeeta Rathi, Kate Cridland, Shannon E Munteanu, Peter Malliaras

Journal: Musculoskeletal science & practice 2023;65():102748

PMID: 37030090

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

The aims of the scoping review were to: (1) evaluate how commonly trialists assess and report adherence to exercise intervention for common musculoskeletal conditions and (2) report the levels of adherence to exercise for musculoskeletal conditions and whether this was influenced by variables of interest.

METHODS

Medline, Cinahl, Embase, Emcare, and SPORTDiscus databases were searched using predefined terms. Published randomised controlled trials were included. Trials were included if they investigated the effectiveness of an exercise intervention for low back pain, shoulder pain, Achilles tendinopathy and knee osteoarthritis (we selected a priori as indicative common musculoskeletal conditions). Data extraction was performed independently by teams of two reviewers. Descriptive consolidation and qualitative synthesis were performed.

RESULTS

321 trials were included; less than half (46.7%, 150/321) measured adherence. When adherence was assessed, 21% (31/150) of trials did not report the results. Adherence levels were greater when people were supervised. Reporting adherence was more common in registered trials. Adherence was measured most frequently via self-report (47.3%, 71/150) followed by supervised sessions (32.0%, 48/150) or combination of both (20.7%, 31/150). The majority of trials (97.0%, 97/100) reported the level of adherence in terms of a frequency.

CONCLUSIONS

A majority of trials investigating exercise interventions for common musculoskeletal conditions do not assess exercise adherence. Trials that were registered reported exercise adherence more frequently. The majority of trials measure adherence via self-report with reliance on only one dimension of exercise adherence (frequency).

Address: Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia. Electronic address: [email protected].; Core Advantage Athletic Development, Melbourne, Australia.; Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.; Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.; Victorian Institute of Sport, Melbourne, Australia.; Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Instituet, Sweden.; St John of God Healthcare, Melbourne, Australia.; Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.

DOI: 10.1016/j.msksp.2023.102748

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MeSH Terms: Humans, Achilles Tendon, Tendinopathy, Exercise Therapy, Exercise, Musculoskeletal Diseases