Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review

Abstract

Limited moderate-quality evidence supports using a small number of BCTs to enhance exercise adherence in people with PMSK. Further research should explore the associations and synergies between BCTs and explicitly report how theory was utilized. This may inform recommendations for health care professionals working with this population. Statement of contribution What is already known on this subject? Exercise (i.e., planned, structured, repetitive movements) improves pain and function in people with persistent musculoskeletal pain (PMSK). Many people with PMSK do not adhere to exercises prescribed by a health care professional. Little research has explored how to enhance adherence to prescribed exercise in people with PMSK. What does this study add? Moderate-quality evidence from eight trials suggests behaviour change interventions enhance exercise adherence. Social support, goal setting, demonstration, instruction, and rehearsal were employed in effective interventions. Interventions with ≤7 behaviour change techniques were more effective at improving adherence than those employing >7.

Effects of Multimodal Intervention Program Among Elite Weightlifters with Knee Pain

“…Therefore, the MKCI intervention program in the current study was designed to have both exercise-based intervention and self-management care complemented with patient education. Psychosocial theories such as theory of planned behavior, theory of reasoned action supports how understanding and knowledge is crucial for positive attitude and healthy behavior (21,22). Perhaps, the improved KSC scores could suggest that the positive outcomes of the study might be due to the improved knowledge base and successful engagement of the athletes with the MKCI in self-managing their knee pain.…”

“…All of the study measures showed significant improvements at the end of 16th week while there were no statistical differences in QOPL. Perhaps, this could be due to short time frame when the measurements were taken at 16th week as the desired interventional effect was reported to occur after 6 months of adherence to the intervention program (22). In future studies, a long-term evaluation of the measures at the 3rd and 6th months may be necessary.…”

Use of the nominal group technique to identify UK stakeholder views of the measures and domains used in the assessment of therapeutic exercise adherence for patients with musculoskeletal disorders

“…These reviews investigated exercise adherence measures for different purposes or environments and, coupled with our work, highlight the overall poor quality of these exercise adherence measures for all contexts and provide critical insight into the many failings of published measures of exercise adherence. However, we are aware that since this study was conducted, the Exercise Adherence Rating Scale (EARS) has been developed and preliminary testing of face and construct validity, internal consistency and reliability suggest that it is a promising new measure of exercise adherence in patients with MSK disorders 41 42. There remains a pressing need to prioritise further development of good quality measures that capture adherence to therapeutic exercise.…”

Fibromyalgia Self‐Management: Mapping the behaviour change techniques used in a practice‐based programme

“…There is a growing evidence base that demonstrates that interventions that include behaviour change techniques are effective and improve outcomes (Eisele, Schagg, Kraemer, Bengel, & Goehner, 2019). In particular, those interventions that combine behaviour change techniques such as self-monitoring of behaviour, goal setting, providing feedback on the performance and reviewing behaviour goals have greater effect (Dombrowski et al, 2012;Michie, Abraham, Whittington, McAteer, & Gupta, 2009 another systematic literature review suggested that less than seven behaviour change techniques are more likely to have a beneficial effect, arguing that it is better to perform a few BCT competently than many poorly (Meade, Bearne, Sweeney, Alageel, & Godfrey, 2019).…”