A systematic review of measures of adherence to physical exercise recommendations in people with stroke

Levy, Tamina; Laver, Kate; Killington, Maggie; Lannin, Natasha A.; Crotty, Maria

doi:10.1177/0269215518811903

Cited by 32 publications

(34 citation statements)

References 77 publications

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“…Three SR covering 162 individual studies and describing 76 ways of measuring non-adherence to prescribed exercise interventions were identified. [114][115][116] Currently, there is no gold standard measurement of adherence to exercise. The existing ones can be categorised as (1) (self-developed) questionnaires, scales, interviews or surveys (eg, asking for exercise-frequencies) 117 ; (2) diaries or logbooks (eg, counting frequencies) 118 and (3) other type of assessments (eg, different types of monitors and devices, such as StepWatch Activity Monitor (SAM)).…”

Section: Train In Proper Execution Of Physical Exercisesmentioning

confidence: 99%

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider

et al. 2020

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ObjectiveTo analyse how non-adherence to prescribed treatments might be prevented, screened, assessed and managed in people with rheumatic and musculoskeletal diseases (RMDs).MethodsAn overview of systematic reviews (SR) was performed in four bibliographic databases. Research questions focused on: (1) effective interventions or strategies, (2) associated factors, (3) impact of shared decision making and effective communication, (4) practical things to prevent non-adherence, (5) effect of non-adherence on outcome, (6) screening and assessment tools and (7) responsible healthcare providers. The methodological quality of the reviews was assessed using AMSTAR-2. The qualitative synthesis focused on results and on the level of evidence attained from the studies included in the reviews.ResultsAfter reviewing 9908 titles, the overview included 38 SR on medication, 29 on non-pharmacological interventions and 28 on assessment. Content and quality of the included SR was very heterogeneous. The number of factors that may influence adherence exceed 700. Among 53 intervention studies, 54.7% showed a small statistically significant effect on adherence, and all three multicomponent interventions, including different modes of patient education and delivered by a variety of healthcare providers, showed a positive result in adherence to medication. No single assessment provided a comprehensive measure of adherence to either medication or exercise.ConclusionsThe results underscore the complexity of non-adherence, its changing pattern and dependence on multi-level factors, the need to involve all stakeholders in all steps, the absence of a gold standard for screening and the requirement of multi-component interventions to manage it.

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Section: Train In Proper Execution Of Physical Exercisesmentioning

confidence: 99%

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider

et al. 2020

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“…(Bollen et al, ) Also, there is no existing literature on the psychometric properties of adherence measure specific to stroke. (Levy et al, ) Thus, SS‐MAHE could be one of the first valid and reliable measures of adherence to home‐based exercises after a stroke. Future studies can test and establish other psychometric properties of SS‐MAHE.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, outcome measures for exercise adherence that are developed for other disease population cannot be deployed for stroke survivors. Furthermore, there are no uniform or standardized methods to measure exercise adherence in stroke (Levy, Laver, Killington, Lannin, & Crotty, 2018).…”

mentioning

confidence: 99%

Measurement of adherence to home‐based exercises among community‐dwelling stroke survivors in India

Mahmood

Solomon

English

et al. 2019

Physiotherapy Res Intl

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Objectives To develop an adherence questionnaire specific to stroke and measure the level of adherence to home‐based exercises among community‐dwelling stroke survivors. Methods We developed and validated the “Stroke‐Specific Measure of Adherence to Home‐based Exercises” (SS‐MAHE). We measured the exercise adherence among 92 community‐dwelling stroke survivors in a cross‐sectional study. Results The SS‐MAHE has two sections covering (a) the dosage of prescribed exercises and (b) dosage of actual exercises done by the participants. It was found to be reliable with ICC score of 0.81 (95% CI, 0.44, 0.94, p = .001.) Adherence was measured by comparing prescribed exercises to the actual exercises performed at home. We rated participants as “adherent” if they were following more than 70% of the prescribed exercise dosage. In our sample of 92 stroke survivors, only 28% of participants were adherent to prescribed home‐based exercises. Conclusion SS‐MAHE is a practical and reliable tool to measure adherence to home‐based exercises after a stroke. Exercise adherence among stroke survivors is less than ideal. There is a need for strategies to specifically target exercise adherence in stroke survivors.

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“…A study exploring the viability of using a tablet to monitor an upper limb exercise program in people with stroke demonstrated that all participants were able to manage the technology independently or with minimal support [5]. However, measuring adherence to rehabilitation programs is challenging, and consensus regarding the gold standard is lacking [6,7]. Accelerometers are relatively new wearable sensors, designed to measure movement in activity counts [8].…”

Section: Introductionmentioning

confidence: 99%

Does the addition of concurrent visual feedback increase adherence to a home exercise program in people with stroke: a single-case series?

Levy¹,

Crotty

Laver

et al. 2020

Preprint

Self Cite

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ObjectiveEvidence is accumulating for the potential benefits of technology use in stroke rehabilitation.However, few studies have examined ways in which technology can be used to increase adherence to programs after discharge from rehabilitation. The aim of this study was to determine if the addition of concurrent visual feedback, via a tablet computer, increased adherence to an exercise program following stroke. Ten participants were provided with a self-administered exercise program and were asked to perform 60 minutes of the exercises daily. After a baseline phase (one week), participants were given a tablet computer (two weeks) and were asked to video record each exercise session. The tablet computer was removed during the fourth week of the program. ResultsExercise duration over the four weeks was investigated using the two-standard deviation (2 SD) band method. A statistically significant effect was observed in four out of ten cases, demonstrated by two successive data points occurring outside the 2 SD band during the intervention phase, suggesting that adherence was increased in response to the tablet computer use. This preliminary study indicates that the use of visual feedback, via a tablet computer, may increase adherence to an exercise program in people with stroke.

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A systematic review of measures of adherence to physical exercise recommendations in people with stroke

Cited by 32 publications

References 77 publications

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider

Measurement of adherence to home‐based exercises among community‐dwelling stroke survivors in India

Does the addition of concurrent visual feedback increase adherence to a home exercise program in people with stroke: a single-case series?

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