Understanding barriers to adherence to home exercise programs in patients with musculoskeletal neck pain.
Adherence
Compliance
Home exercise program
Neck pain
Physiotherapy
Journal
Musculoskeletal science & practice
ISSN: 2468-7812
Titre abrégé: Musculoskelet Sci Pract
Pays: Netherlands
ID NLM: 101692753
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
07
11
2022
revised:
05
01
2023
accepted:
16
01
2023
pubmed:
29
1
2023
medline:
3
3
2023
entrez:
28
1
2023
Statut:
ppublish
Résumé
Home exercise program (HEP) prescription is commonplace in physical therapy (PT). Adherence to HEPs is generally poor, with non-adherence as high as 70%. Poor adherence may negatively impact outcomes. To (i) qualitatively assess patients' thoughts and beliefs regarding HEP performance and (ii) quantitatively define the relationship between adherence to HEPs and functional outcomes and identify variables that impact adherence. Mixed-methods. Part 1 involved semi-structured interviews with patients attending PT for neck pain. Responses were assessed using thematic analysis. Part 2 involved a retrospective chart review of patients seen in outpatient PT for neck pain. Between-group (adherent and non-adherent) differences in functional scores were analyzed using a linear mixed model. Sex, age, and functional score data was entered into a regression model to explore their ability to predict adherence. 25 participants were interviewed. Qualitative analysis revealed the following themes associated with adherence to a HEP: (i) prior PT, (ii) observability of outcomes, (iii) expectations of PT, and (iv) experience of pain. Retrospective data from 187 patients was analyzed. Functional scores at discharge were significantly higher (p = 0.03, mean difference = 12.4) in the adherent group. Age (OR = 0.98; 95% CI = 0.93-1.02), male sex (OR = 1.23; 95% CI = 0.22-6.91), and functional scores at intake (OR = 0.99; 95% CI = 0.92-1.07) were not significant predictors of non-adherence. Individual patient experiences such as delayed improvement in symptoms and/or experience of pain associated with HEP performance may contribute to poor adherence to HEPs. Adherence to a HEP was associated with superior functional outcomes compared to non-adherence. Age, sex, and functional scores were not predictors of non-adherence.
Sections du résumé
BACKGROUND
Home exercise program (HEP) prescription is commonplace in physical therapy (PT). Adherence to HEPs is generally poor, with non-adherence as high as 70%. Poor adherence may negatively impact outcomes.
OBJECTIVES
To (i) qualitatively assess patients' thoughts and beliefs regarding HEP performance and (ii) quantitatively define the relationship between adherence to HEPs and functional outcomes and identify variables that impact adherence.
DESIGN
Mixed-methods.
METHOD
Part 1 involved semi-structured interviews with patients attending PT for neck pain. Responses were assessed using thematic analysis. Part 2 involved a retrospective chart review of patients seen in outpatient PT for neck pain. Between-group (adherent and non-adherent) differences in functional scores were analyzed using a linear mixed model. Sex, age, and functional score data was entered into a regression model to explore their ability to predict adherence.
RESULTS
25 participants were interviewed. Qualitative analysis revealed the following themes associated with adherence to a HEP: (i) prior PT, (ii) observability of outcomes, (iii) expectations of PT, and (iv) experience of pain. Retrospective data from 187 patients was analyzed. Functional scores at discharge were significantly higher (p = 0.03, mean difference = 12.4) in the adherent group. Age (OR = 0.98; 95% CI = 0.93-1.02), male sex (OR = 1.23; 95% CI = 0.22-6.91), and functional scores at intake (OR = 0.99; 95% CI = 0.92-1.07) were not significant predictors of non-adherence.
CONCLUSIONS
Individual patient experiences such as delayed improvement in symptoms and/or experience of pain associated with HEP performance may contribute to poor adherence to HEPs. Adherence to a HEP was associated with superior functional outcomes compared to non-adherence. Age, sex, and functional scores were not predictors of non-adherence.
Identifiants
pubmed: 36709090
pii: S2468-7812(23)00007-3
doi: 10.1016/j.msksp.2023.102722
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102722Informations de copyright
Copyright © 2023 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.