Recommendations for Improving Adherence to Home-Based Exercise: A Systematic Review

Abstract

Purpose The aim of this review is to list the factors that influence adherence to home-based exercise, and to make recommendations about how to improve adherence. Materials and Methods A literature search was performed in Web of Science Core Collection (Library of ETH Zurich), PubMed and PEDro databases. The following search categories were used: “physiotherapy”, “home-based exercises”, “adherence”, “effectiveness”, “motivation” and “barriers”. Results A total of 38 studies were identified and title and abstract analysis was performed. 14 studies were included for further analysis. The factors found to contribute to adherence to home-based exercise programmes are: intensive social support and guidance from a physiotherapist; prescription of a low number of exercises (<4); high levels of self-motivation and self-efficacy; and a lack of psychological influences, such as helplessness, depression and anxiety. Conclusion Adherence to home-based exercise could be increased relatively simply, through provision of good support of the patient from physiotherapists, instruction of 2 to a maximum of 4 exercises, and by increasing the patients’ self-motivation and self-efficacy (Recommendation level B+).

Efficacy of home‐based exercise programme on physical function after hip fracture: a systematic review and meta‐analysis of randomised controlled trials

“…Patients' adherence to home‐based exercise is central to the success of the therapy. Previous studies showed that social support from family members or friends, increased motivation by physical therapy, education, and proper number of exercises are main supporting factors to improve adherence to home‐based exercise . A comprehensive subject group, including physiotherapists, social workers, and family members, is required to evaluate and provide interventions for patients with hip fractures who attend home exercise programmes, which may help to ensure an improvement in patients' adherence to the whole rehabilitation process.…”

Health beliefs, attitudes, and health-related quality of life in persons with fibromyalgia: mediating role of treatment adherence

“…Consistent with previous literature, adherence was correlated with health self-efficacy and mental and physical HRQL, and we extend these findings to include the explanatory role of treatment adherence. Conceptually, self-efficacy is the self-evaluation of one's ability to carry out contextually-specific behaviors and to access the cognitive-motivational resources necessary for behavior (Bachmann, Oesch, & Bachmann, 2018;Deci & Ryan, 2000). Persons with fibromyalgia who feel more efficacious and masterful in their ability to achieve health-related goals, and who have the self-perceived cognitive resources to do so may, in turn, feel more competent to adhere to treatment, thereby improving HRQL (López-Larrosa, 2013;McGuckin, Prentice, McLaughlin, & Harkin, 2012).…”

Review article: impact of exercise on physical frailty in patients with chronic liver disease

“…Supervised programmes provide structure, camaraderie and access to regular health care professional support, yet can be difficult for patients to adhere to due to cost/time of travel and fluctuating health status. Unsupervised, home‐based exercise provides flexibility, limits patient travel and promotes independent lifestyle changes in the patient's own environment . However, despite weekly telephone support and fortnightly observations, the overall adherence rate in the home‐based exercise study conducted by Kruger et al was low (55%).…”