Predictors of Exercise Adherence in Patients With Meniscal Tear and Osteoarthritis

Abstract

Objective To identify predictors of poor exercise adherence in patients with osteoarthritis (OA) and meniscal tear. Design Secondary analysis of data gathered over the first 12 weeks in the Meniscal Tear in Osteoarthritis Research (MeTeOR) Trial, a multicenter, randomized controlled trial. Setting Seven referral centers in the US. Participants This analysis was conducted in 325 of the 351 MeTeOR patients, each of whom was ≥ 45 years old and had meniscal tear and osteoarthritic changes on imaging studies; 26 were excluded due to missing data from which to derive the primary outcome variable. Interventions All patients received a structured supervised exercise program focused on strengthening, along with prescribed home exercises; half were randomized to also receive arthroscopic partial meniscectomy. Main Outcome Measure Poor exercise adherence through 12 weeks, defined as performing <50% of prescribed exercise. Results 38% of the MeTeOR cohort showed poor exercise adherence. In the multivariate model, adjusting for treatment group, those who earned ≤ $29,000/year had 1.64 times the risk of non-adherence (95% CI: 1.10, 2.43) than those who earned >$100,000 /year; and, those without baseline pain with pivoting and twisting had 1.60 times greater risk of non-adherence than those with these symptoms (95% CI: 1.14, 2.25). Conclusion Low income was associated with poor exercise adherence among patients ≥ 45 with osteoarthritis and meniscal tear, as was absence of pain with pivoting and twisting. Our findings highlight the need for further research into exercise adherence and for interventions to enhance adherence among those with low incomes.

Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated OA care model: Secondary analyses from a cluster-randomised stepped wedge trial

“…None of the demographic or baseline patient-reported measures were significantly associated with completing the exercise programme among the intervention group participants. A previous study has pointed to low-income and no baseline pain with pivoting and twisting as predictors for nonadherence to exercise in patients with meniscal tears and knee osteoarthritis (38). Our data also indicates that participants not completing the exercise programme have a lower symptom burden at baseline compared to the completers.…”

Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated osteoarthritis care model: secondary analyses from a cluster-randomised stepped-wedge trial

“…Patient motivation and beliefs may be important factors to consider [36].v None of the demographic or baseline patient-reported measures were significantly associated with completing the exercise programme among the intervention group participants. A previous study has pointed to low-income and no baseline pain with pivoting and twisting as predictors for non-adherence to exercise in patients with meniscal tears and knee osteoarthritis [37]. Our data also indicates that participants not completing the exercise programme have a lower symptom burden at baseline compared to the completers.…”

Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated OA care model: Secondary analyses from a cluster-randomised controlled trial

“…None of the demographic or baseline patient-reported measures were significantly associated with completing the exercise programme among the intervention group participants. A previous study has pointed to low-income and no baseline pain with pivoting and twisting as predictors for nonadherence to exercise in patients with meniscal tears and knee osteoarthritis (34). Our data also indicates that participants not completing the exercise programme have a lower symptom burden at baseline compared to the completers.…”