Non-adherence to prescribed home rehabilitation exercises for musculoskeletal injuries: The role of the patient-practitioner relationship

Wright, Bradley J.; Galtieri, Nicholas Justin; Fell, Michelle

doi:10.2340/16501977-1241

Cited by 58 publications

(51 citation statements)

References 31 publications

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“…[33]; musculoskeletal injury [21]; and dizziness [19]. However, these associations did not remain significant in multivariate analyses suggesting that the other factors taken into account, including intention [19,36], previous adherence behaviour [36], difficulty remembering to do exercises [37], and practitioner-client relationship factors [21] were at least partially responsible for these effects.…”

Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

“…Other HBPTs investigated were for stroke rehabilitation [51]; osteoporosis [18]; rheumatoid arthritis [52], and ankle sprains [53]. Three studies [1,21,54] investigated participants engaged in home physical rehabilitation for a variety of musculoskeletal conditions. All measures of adherence included participant self-report.…”

Section: Methodological Overview Of Studiesmentioning

confidence: 99%

“…The mean age of samples was also often determined by the condition investigated. Owing to the exclusion of studies with exclusively non-adult samples, all except four studies [1,21,32,33] only included participants over 18. The minimum age of any participant recruited was 14, but all participants conducted their physiotherapy independently.…”

Section: Methodological Overview Of Studiesmentioning

confidence: 99%

“…Two aspects of participants' perceptions regarding their ability to complete their HBPTs were investigated by twelve studies: perceptions of self-efficacy [20,21,32,33,[36][37][38]41,46,47], perceived behavioural control (PBC) [19,39]. The similarity between these constructs has previously been acknowledged [61] and as such, the findings pertaining to these factors are considered together.…”

Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

“…The similarity between these constructs has previously been acknowledged [61] and as such, the findings pertaining to these factors are considered together. Ten of these studies [19][20][21]32,[36][37][38]41,46,47] provided evidence of an association with adherence. Three [20,38,46] found that patients reporting higher self-efficacy were more likely to be adherent to HBPTs for chronic neck and back pain [20], upper limb impairments [46], and urinary incontinence [38] suggesting that the importance of self-efficacy for adherence is not limited to a specific patient population.…”

Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

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Predictors of adherence to home-based physical therapies: a systematic review

Essery

Geraghty

Kirby

et al. 2016

Disability and Rehabilitation

226

177

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Disability and Rehabilitation F o r P e e r R e v i e w Running head: Adherence to home-based physical therapies Implications for Rehabilitation• Non-adherence to physical rehabilitation therapies is often high -particularly in selfmanaged, home-based programmes, despite good adherence being important in achieving positive outcomes.• The findings of this systematic review indicate that greater self-efficacy, self-motivation, social support, intentions and previous adherence to physical therapies predict higher adherence to HBPTs.• Assessment of these domains before providing individuals with their HBPT regimes may allow identification of 'risk factors' for poor adherence. These can then potentially be addressed or managed prior to, or alongside, the therapy.• Interventions to support patients' self-managed physical rehabilitation should include elements designed to enhance patients' self-efficacy, self-motivation and social support given the evidence that these factors are good predictors of adherence. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 focused largely on clinic-based physiotherapy. The objective of this review, therefore, was to identify specific factors which influence adherence to home-based, self-managed physical therapies. Method: A systematic review was conducted in which eight online databases were searched using combinations of key terms relating to physical therapies, adherence and predictors. Matching records were screened against eligibility criteria and 30 quantitative articles were quality assessed and included in the final review. Relevant data were extracted and a narrative synthesis approach was taken to aggregating findings across studies. Results:There was relatively strong evidence that the following factors predicted adherence to HBPTs: intention to engage in the HBPT, self-motivation, self-efficacy, previous adherence to exercise-related behaviours, and social support. Conclusions: This review has identified a range of factors that appear to be related to patients' adherence to their self-managed physical rehabilitation therapies. Awareness of these factors may inform design of interventions to improve adherence. Key words:Adherence, physiotherapy, self-management, predictors recommendations from a health care provider" [7]. Within the field of rehabilitation, the term 'engagement' is also increasingly used in relation to patients' self-management of their health. This term not only encompasses notions of whether a patient's behaviour is adherent, but also of interaction with professionals and identifying relevant information too [8][9][10]. Whilst important to acknowledge this broader concept of engagement, the focus of this review is primarily upon...

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Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

Section: Methodological Overview Of Studiesmentioning

confidence: 99%

Section: Methodological Overview Of Studiesmentioning

confidence: 99%

Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

Section: Perceptions Of Ability To Complete Therapymentioning

confidence: 99%

See 3 more Smart Citations

Predictors of adherence to home-based physical therapies: a systematic review

Essery

Geraghty

Kirby

et al. 2016

Disability and Rehabilitation

226

177

View full text Add to dashboard Cite

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A qualitative study exploring the views of individuals with knee osteoarthritis on the role of physiotherapists in weight management: A complex issue requiring a sophisticated skill set

Allison

Delany

Setchell

et al. 2019

Musculoskeletal Care

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Objectives The aim of the present study was to explore the attitudes of individuals with knee osteoarthritis (OA) towards the role of physiotherapists in weight management in knee OA. Methods The study took the form of a qualitative semi‐structured telephone interview study. Participants included 13 purposively sampled individuals with symptomatic knee OA who were overweight or obese by body mass index. Each participated in a semi‐structured telephone interview exploring their perspectives regarding the potential role of physiotherapists in weight management in knee OA. Data were transcribed and analysed using a thematic approach. Results Three main themes were identified, which highlighted that individuals with knee OA: (a) recognize that weight management is complex; (b) consider that a special skill set is required by clinicians for weight management; and (c) expressed ambivalence towards physiotherapists' role in weight management, with a focus on the role of exercise prescription. Conclusions Although participants were open to physiotherapists taking on a weight management role within a multidisciplinary team, they were uncertain about whether physiotherapists had the skills and scope of practice needed to address this complex issue. The findings highlight the importance of engagement by physiotherapists in meaningful dialogue with patients, to understand better their experiences, expectations and preferences, and establish if, when and how to integrate patients in weight management discussions in the treatment plan for their knee OA.

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Do behaviour change techniques increase adherence to home exercises in those with upper extremity musculoskeletal disorders? A systematic review

Thacker

Bosello

Ridehalgh

2020

Musculoskeletal Care

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Objectives: To investigate whether behaviour change techniques (BCTs) can influence adherence to home exercise in people with upper extremity musculoskeletal disorders (UEMD). Design:A systematic review of randomised control trials, non-randomised control trials, case-control studies and cohort studies. Results were presented narratively.Participants were those with UEMD. The intervention was any home exercise programme, alongside a BCT designed to increase exercise adherence. Any duration of intervention was accepted. The main outcome sought was adherence to home exercise. A systematic search was performed on four online databases. Grey literature was searched. Results:The search resulted in 28,755 titles. 77 full-text articles were assessed for eligibility. Six studies were included in the qualitative synthesis. Four studies had Some Concern of Bias, whilst two studies had High Risk of Bias. Three studies found statistically significant differences in exercise adherence (p < 0.05) between the Intervention group and Control group. The BCT 'Social Support (unspecified)' was used within all studies that found significant differences in adherence levels at outcome. However, multiple BCTs were received by the Intervention groups within all studies, making it impossible to identify the effects of any single BCT upon adherence levels. Conclusion:Social support may be relevant in patients' adherence levels to HEPs. However, confidence in the results is uncertain given the small number of studies found, and their High RoB. Future studies should validate their measurement and definition of adherence, as well as the number of BCTs they use, to provide reproducible evidence.

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Non-adherence to prescribed home rehabilitation exercises for musculoskeletal injuries: The role of the patient-practitioner relationship

Abstract: These preliminary results suggest that the patient-practitioner relationship is the best predictor of adherence to HRE, and that improving patient perception of the clinician's productivity, communication of information and trust during consultations may improve adherence to HRE.

Cited by 58 publications

References 31 publications

Predictors of adherence to home-based physical therapies: a systematic review

Predictors of adherence to home-based physical therapies: a systematic review

A qualitative study exploring the views of individuals with knee osteoarthritis on the role of physiotherapists in weight management: A complex issue requiring a sophisticated skill set

Do behaviour change techniques increase adherence to home exercises in those with upper extremity musculoskeletal disorders? A systematic review

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