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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2018; 28(01): 20-31
DOI: 10.1055/s-0043-120527
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

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

Empfehlungen zur Verbesserung der Adhärenz zu Heimübungsprogrammen: Eine Übersichtsarbeit
Caroline Bachmann
1   Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
,
Peter Oesch
2   Department of Physiotherapy, Kliniken Valens, Valens, Switzerland
,
Stefan Bachmann
3   Department of Rheumatology, Kliniken Valens, Valens, Switzerland
› Author Affiliations
Further Information

Publication History

received 18 May 2017

accepted 28 September 2017

Publication Date:
18 December 2017 (online)

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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+).

Zusammenfassung

Fragestellung Das Ziel der Übersichtsarbeit ist eine systematische Auflistung von relevanten Faktoren, die die Adhärenz zu Heimübungsprogrammen beeinflussen können, und aus diesen Resultaten Empfehlungen abzuleiten, wie die Adhärenz gesteigert werden kann.

Material und Methoden Es wurde eine systematische Literaturrecherche in den Datenbanken Web of Science Core Collection (Bibliothek der ETH Zürich), PubMed und PEDro durchgeführt. Die folgenden Suchkategorien wurden verwendet: „physiotherapy“, „home-based exercise“, „adherence“, „effectiveness“, „motivation“ und „barriers“.

Ergebnisse Es konnten 38 Studien identifiziert werden, von denen nach der Titel- und Abstractanalyse noch 14 Arbeiten in die Übersichtsarbeit einbezogen wurden. Die Resultate zeigen, dass vor allem intensive soziale Unterstützung und Führung durch einen Physiotherapeuten, geringe Anzahl instruierter Übungen (<4), hohe Selbstmotivation und Selbstwirksamkeit und nicht vorhanden sein von psychologischen Einflüssen wie Hilfslosigkeit, Depressionen und Angstzustände zur Adhärenz zu einem Heimübungsprogramm beitragen können.

Schlussfolgerung Durch eine gute Begleitung des Patienten durch Physiotherapeuten, durch die Instruktion von 2 – max. 4 Übungen und durch Erhöhung der Selbstmotivation und Selbstwirksamkeit der Patienten kann die Adhärenz zu Heimübungsprogrammen relativ einfach gesteigert werden (Recommendation level B+).

Key words

home-based exercise - adherence - influencing factors - recommendations - review

Schlüsselwörter

Heimübungsprogramme - Adhärenz - Einflussfaktoren - Empfehlungen - Review
 

  • Literatur

  • 1 Yu-Yahiro JA, Resnick B, Orwig D. et al. Design and implementation of a home-based exercise program post-hip fracture: the Baltimore hip studies experience. PM & R: the journal of injury, function, and rehabilitation 2009; 1: 308-318
    CrossrefPubMedGoogle Scholar
  • 2 Ashari A, Hamid TA, Hussain MR. et al. Effectiveness of individualized home-based exercise on turning and balance performance among adults older than 50 yrs: a randomized controlled trial. Am J Phys Med Rehab 2016; 95: 355-365
    PubMedGoogle Scholar
  • 3 Anar SO. The effectiveness of home-based exercise programs for low back pain patients. J Phys Ther Sci 2016; 28: 2727-2730
    CrossrefPubMedGoogle Scholar
  • 4 Hill KD, Hunter SW, Batchelor FA. et al. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: a systematic review and meta-analysis. Maturitas 2015; 82: 72-84
    CrossrefPubMedGoogle Scholar
  • 5 Thomas KS, Muir KR, Doherty M. et al. Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial. BMJ (Clinical research ed) 2002; 325: 752
    CrossrefPubMedGoogle Scholar
  • 6 Latham NK, Harris BA, Bean JF. et al. Effect of a home-based exercise program on functional recovery following rehabilitation after hip fracture: a randomized clinical trial. JAMA 2014; 311: 700-708
    CrossrefPubMedGoogle Scholar
  • 7 Anwer S, Alghadir A, Brismee JM. Effect of home exercise program in patients with knee osteoarthritis: a systematic review and meta-analysis. Journal of Geriatric Physical Therapy (2001) 2016; 39: 38-48
    CrossrefPubMedGoogle Scholar
  • 8 O’Reilly SC, Muir KR, Doherty M. Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: a randomised controlled trial. Annals of the Rheumatic Diseases 1999; 58: 15-19
    CrossrefPubMedGoogle Scholar
  • 9 Frih ZBS, Fendri Y, Jellad A. et al. Efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain: a randomized, controlled study. Ann Phys Rehabil Med 2009; 52: 485-496
    CrossrefPubMedGoogle Scholar
  • 10 Essery R, Geraghty AW, Kirby S. et al. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil 2016; DOI: 10.3109/09638288.2016.1153160: 1-16.
    PubMedGoogle Scholar
  • 11 Sabaté E. Adherence to long-term therapies: evidence for action. World Health Organization; 2003
    Google Scholar
  • 12 Jack K, McLean SM, Moffett JK. et al. Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Man Ther 2010; 15: 220-228
    CrossrefPubMedGoogle Scholar
  • 13 Palazzo C, Klinger E, Dorner V. et al. Barriers to home-based exercise program adherence with chronic low back pain: patient expectations regarding new technologies. Ann Phys Rehabil Med 2016; 59: 107-113
    CrossrefPubMedGoogle Scholar
  • 14 Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol-Int Rev 2008; 57: 1-29
    PubMedGoogle Scholar
  • 15 Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol 2011; 56: 161-170
    CrossrefPubMedGoogle Scholar
  • 16 Howick J, Chalmers I, Glasziou P et al. The Oxford Levels of Evidence 2. In, Oxford Centre for Evidence-Based Medicine
    PubMed
  • 17 Minor MA, Brown JD. Exercise maintenance of persons with arthritis after participation in a class experience. Health Education Quarterly 1993; 20: 83-95
    CrossrefPubMedGoogle Scholar
  • 18 Sluijs EM, Kok GJ, van der Zee J. Correlates of exercise compliance in physical therapy. Physical Therapy 1993; 73: 771-782
    CrossrefPubMedGoogle Scholar
  • 19 Jordan JL, Holden MA, Mason EE. et al. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2010; DOI: 10.1002/14651858.CD005956.pub2: CD005956.
    PubMedGoogle Scholar
  • 20 Henry KD, Rosemond C, Eckert LB. Effect of number of home exercises on compliance and performance in adults over 65 years of age. Physical Therapy 1999; 79: 270-277
    CrossrefPubMedGoogle Scholar
  • 21 Medina-Mirapeix F, Escolar-Reina P, Gascon-Canovas JJ. et al. Predictive factors of adherence to frequency and duration components in home exercise programs for neck and low back pain: an observational study. BMC Musculoskelet Disord 2009; 10: 155
    CrossrefPubMedGoogle Scholar
  • 22 Eckard T, Lopez J, Kaus A. et al. Home exercise program compliance of service members in the deployed environment: an observational cohort study. Military Medicine 2015; 180: 186-191
    CrossrefPubMedGoogle Scholar
  • 23 Brewer BW, Van Raalte JL, Cornelius AE. et al. Psychological factors, rehabilitation adherence, and rehabilitation outcome after anterior cruciate ligament reconstruction. Rehabil Psychol 2000; 45: 20-37
    CrossrefPubMedGoogle Scholar
  • 24 Beinart NA, Goodchild CE, Weinman JA. et al. Individual and intervention-related factors associated with adherence to home exercise in chronic low back pain: a systematic review. Spine J 2013; 13: 1940-1950
    CrossrefPubMedGoogle Scholar
  • 25 Chen C-Y, Neufeld PS, Feely CA. et al. Factors influencing compliance with home exercise programs among patients with upper-extremity impairment. American Journal of Occupational Therapy 1999; 53: 171-180
    CrossrefPubMedGoogle Scholar
  • 26 McAuley E, Courneya KS, Rudolph DL. et al. Enhancing exercise adherence in middle-aged males and females. Preventive Medicine 1994; 23: 498-506
    CrossrefPubMedGoogle Scholar
  • 27 Schoo AMM, Morris ME, Bui QM. Predictors of home exercise adherence in older people with osteoarthritis. Physiotherapy Canada 2005; 57: 179-187
    CrossrefPubMedGoogle Scholar
  • 28 Brewer BW, Cornelius AE, Van Raalte JL. et al. Predictors of adherence to home rehabilitation exercises following anterior cruciate ligament reconstruction. Rehabil Psychol 2013; 58: 64-72
    CrossrefPubMedGoogle Scholar
  • 29 Garay-Sevilla ME, Nava LE, Malacara JM. et al. Adherence to treatment and social support in patients with non-insulin dependent diabetes mellitus. Journal of Diabetes and its Complications 1995; 9: 81-86
    CrossrefPubMedGoogle Scholar
  • 30 Jeragh-Alhaddad FB, Waheedi M, Barber ND. et al. Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study. Patient Preference and Adherence 2015; 9: 1491-1503
    PubMedGoogle Scholar
  • 31 Osterberg L, Blaschke T. Adherence to medication. New England Journal of Medicine 2005; 353: 487-497
    CrossrefPubMedGoogle Scholar
  • 32 Schäfer B. Barrieren und Förderfaktoren der eigenständigen Durchführung von Übungen. physioscience. 2017; 13: 17-24
    PubMedGoogle Scholar