Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis

Nicolson, P.J.; Bennell, Kim L; Dobson, Fiona; Ginckel, Ans Van; Holden, Melanie; Hinman, Rana S

doi:10.1136/bjsports-2016-096458

Cited by 179 publications

(171 citation statements)

References 55 publications

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“…Adherence interventions that target multiple behavior change techniques have been suggested to improve compliance. Patient specific interventions to improve exercise motivation and reduce barriers to exercise may increase adherence to the exercise protocols . Booster sessions with study team members may also improve retention .…”

Section: Discussionmentioning

confidence: 95%

“…Patient specific interventions to improve exercise motivation and reduce barriers to exercise may increase adherence to the exercise protocols. 39 Booster sessions with study team members may also improve retention. 39 However, a strength of our study is that the intervention was implemented for both genders, including individuals within the age range most affected by OA and at different levels of physical functioning and pain, indicating that the typical individual affected by hip OA would experience similar outcomes as the individuals in this study.…”

Section: Discussionmentioning

confidence: 99%

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A Pilot Randomized Controlled Trial for Aerobic and Strengthening Exercises on Physical Function and Pain for Hip Osteoarthritis

Thompson

Christopherson

Marshall

et al. 2019

PM&R

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Background Hip osteoarthritis (OA) limits lower extremity physical function. Exercise therapy may improve physical function and reduce pain in patients with hip OA. Objective To evaluate the feasibility of a randomized controlled trial (RCT) to measure the effect of a structured hip‐specific resistance and aerobic exercise program on physical function and self‐reported pain in adults with hip OA. Design Pilot RCT. Setting Academic medical center. Participants Thirty one adults with radiographic hip OA. Interventions Participants were randomly allocated in a 2:1 ratio to a 3‐month structured exercise intervention (n = 21) or a 3‐month waitlist control (n = 10). Main Outcome Measures The 6‐minute walk test was the primary outcome measure. Self‐reported physical function was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and pain visual analog scale (VAS). Measures of feasibility were assessed as secondary outcomes. Results From baseline to 3 months, the median change from baseline in distance covered during the 6‐minute walk test in the intervention group (49 m) was double that of the control group (22 m), but the difference was not statistically significant (P = .13). Likewise, the WOMAC physical function subscale score median changes in the intervention group (5 points) were double that of the controls (2 points), although the difference was not statistically significant (P = .06). Median change in pain scores was slightly reduced in each group but not significantly different between groups (P = .53). Conclusion Although no statistically significant between‐group differences were found in this pilot RCT, improvements were seen in measures of physical function compared to controls. A larger RCT of this structured exercise program may be warranted.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

A Pilot Randomized Controlled Trial for Aerobic and Strengthening Exercises on Physical Function and Pain for Hip Osteoarthritis

Thompson

Christopherson

Marshall

et al. 2019

PM&R

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“…For interventions to have an impact on outcomes beyond the several months of follow‐up generally reported in clinical trials, and to be effective in whole populations, wide access to interventions, as well as high adherence, are essential. Recent reviews have highlighted the need for identifying predictors of adherence to lifestyle interventions and barriers to behaviour change, with particular emphasis on the design and evaluation of interventions to improve adherence (Nicolson et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Although their impact is to be demonstrated, experts in OA and consumers have identified and prioritized 21 key messages for people with joint pain associated with OA, which may be used to inform the content of educational materials about important aspects of OA and its management (French et al, 2014). (Nicolson et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Predictors of pain interference and potential gain from intervention in community dwelling adults with joint pain: A prospective cohort study

Blagojevic‐Bucknall

Thomas

Wulff

et al. 2019

Musculoskeletal Care

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Introduction There is little research on identifying modifiable risk factors that predict future interference of pain with daily activity in people with joint pain, and the estimation of the corresponding population attributable risk (PAR). The present study therefore investigated modifiable predictors of pain interference and estimated maximum potential gain from intervention in adults with joint pain. Methods A population‐based cohort aged ≥50 years was recruited from eight general practices in North Staffordshire, UK. Participants (n = 1878) had joint pain at baseline lasting ≥3 months and indicated no pain interference. Adjusted associations of self‐reported, potentially modifiable prognostic factors (body mass index, anxiety/depressive symptoms, widespread pain, inadequate joint pain control, physical inactivity, sleep problems, smoking and alcohol intake) with onset of pain interference 3 years later were estimated via Poisson regression, and corresponding PAR estimates were obtained. Results Inadequate joint‐specific pain control, insomnia and infrequent walking were found to be independently significantly associated with the onset of pain interference after 3 years, with associated PARs of 6.3% (95% confidence interval −0.3, 12.4), 7.6% (−0.4, 15.0) and 8.0% (0.1, 15.2), respectively, with only the PAR for infrequent walking deemed statistically significant. The PAR associated with insomnia, infrequent walking and inadequate control of joint pain simultaneously was 20.3% (8.6, 30.4). Conclusions There is potential to reduce moderately the onset of pain interference from joint pain in the over‐50s if clinical and public health interventions targeted pain management and insomnia, and promoted an active lifestyle. However, most of the onset of significant pain interference in the over‐50s, would not be prevented, even assuming that these factors could be eliminated.

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“…While no single strategy will universally increase exercise adherence or reduce barriers to exercise for all patients, some emerging techniques have been explored. Evidence suggests that returning for further physiotherapy after an initial exercise period and promoting behavioural graded exercise (the self-regulation of gradual increases in exercise incorporated into activities of daily living) may be beneficial 19. It has been shown that group education can help achieve clinical benefits in individuals with hip and/or knee OA.…”

Section: Best Practice In Oa Management (Prevention and Treatment)mentioning

confidence: 99%

Lower extremity osteoarthritis: optimising musculoskeletal health is a growing global concern: a narrative review

et al. 2018

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The burden of non-communicable diseases, such as osteoarthritis (OA), continues to increase for individuals and society. Regrettably, in many instances, healthcare professionals fail to manage OA optimally. There is growing disparity between the strength of evidence supporting interventions for OA and the frequency of their use in practice. Physical activity and exercise, weight management and education are key management components supported by evidence yet lack appropriate implementation. Furthermore, a recognition that treatment earlier in the disease process may halt progression or reverse structural changes has not been translated into clinical practice. We have largely failed to put pathways and procedures in place that promote a proactive approach to facilitate better outcomes in OA. This paper aims to highlight areas of evidence-based practical management that could improve patient outcomes if used more effectively.

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Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis

Cited by 179 publications

References 55 publications

A Pilot Randomized Controlled Trial for Aerobic and Strengthening Exercises on Physical Function and Pain for Hip Osteoarthritis

A Pilot Randomized Controlled Trial for Aerobic and Strengthening Exercises on Physical Function and Pain for Hip Osteoarthritis

Predictors of pain interference and potential gain from intervention in community dwelling adults with joint pain: A prospective cohort study

Lower extremity osteoarthritis: optimising musculoskeletal health is a growing global concern: a narrative review

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