Analysis of Movement-Based Mind–Body Interventions to Guide the Implementation of Osteoarthritis Exercise Programs: A Descriptive Review of Randomized Controlled Trials

Abstract

Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs.Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis.Results: We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were ''starting level rule'' (n = 1, 5%) and ''progression rule'' (n = 1, 5%). Other incompletely reported items included ''fidelity or adherence (planned)'' (n = 9, 41%), ''motivations'' (n = 9, 41%), and ''progression description'' (n = 5, 23%).Conclusions: The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.

If exercise is medicine, why don’t we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease

“…We identified 7804 studies and included 28 systematic reviews18–20 22 24 34 35 37–57 (figure 1). These 28 reviews included 1467 studies comprised of 1724 interventions.…”

“…A list of the studies excluded during full-text assessment, with reasons, is provided in online supplemental appendix 5. Ten reviews only used CERT,35 38 41 42 44 48 52–54 56 11 reviews only used TIDieR,18–20 24 39 45–47 50 51 55 and 6 reviews22 34 37 40 43 57 used both CERT and TIDieR (table 2). One review38 used a hybrid tool comprised of items 1–5, 7, and 9–12 from TIDieR, complemented and expanded upon by items 6 and 8 of CERT.…”

“…The median number of interventions included in the reviews was 24 (range 3–287, IQR 67). Twelve reviews assessed quality of reporting in musculoskeletal conditions,19 34 35 37 38 40–42 45 48 56 57 four in neurological conditions,39 47 51 53 six in cardiovascular conditions,18 20 22 24 49 55 one in cancer50 and five in ‘other’ conditions including urinary dysfunction (n=1),44 pelvic organ prolapse (n=1)43 organ transplant patients (n=2),46 52 and older adults (n=1) 54. See table 2 for all characteristics of included reviews.…”