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*Dagens forskningsoversigt fra Scias Update:*
Behaviour change techniques associated with adherence to prescribed
exercise in patients with persistent musculoskeletal pain: Systematic
review.
Br J Health Psychol. 2019 02;24(1):10-30
Authors: Meade LB, Bearne LM, Sweeney LH, Alageel SH, Godfrey EL
Abstract
PURPOSE: Exercise (planned, structured, repetitive movement) improves pain
and function in people with persistent musculoskeletal pain (PMSK), but
adherence is often poor. This systematic review evaluates the evidence from
randomized controlled trials (RCTs) on the effectiveness of interventions
to improve exercise adherence in people with PMSK and describes the
content, context, and theoretical underpinning of behaviour change
interventions designed to increase adherence.
METHODS: Nine electronic databases were searched from inception dates to
August 2017. Studies were included if they were RCTs that included adults
with PMSK ≥3 months; ≥one measure of exercise adherence, exercise
prescribed to both groups, and employed ≥one behaviour change technique
(BCT) in the treatment group. Independent data extraction, theory coding,
BCT taxonomy coding, and quality assessment using Cochrane Risk of Bias
(RoB) tool was conducted by two reviewers.
RESULTS: Eight RCTs (five low, three high RoB) met inclusion criteria. Five
trials reported between-group differences in exercise adherence, favouring
the treatment group. Three trials reported theoretical underpinning. There
was moderate evidence that five BCTs, social support, goal setting,
instruction of behaviour, demonstration of behaviour, and
practice/rehearsal, improved exercise adherence. Interventions employing
≤seven BCTs, unique to those included in the control group, were most
effective at enhancing exercise adherence.
CONCLUSIONS: Limited moderate-quality evidence supports using a small
number of BCTs to enhance exercise adherence in people with PMSK. Further
research should explore the associations and synergies between BCTs and
explicitly report how theory was utilized. This may inform recommendations
for health care professionals working with this population. Statement of
contribution What is already known on this subject? Exercise (i.e.,
planned, structured, repetitive movements) improves pain and function in
people with persistent musculoskeletal pain (PMSK). Many people with PMSK
do not adhere to exercises prescribed by a health care professional. Little
research has explored how to enhance adherence to prescribed exercise in
people with PMSK. What does this study add? Moderate-quality evidence from
eight trials suggests behaviour change interventions enhance exercise
adherence. Social support, goal setting, demonstration, instruction, and
rehearsal were employed in effective interventions. Interventions with ≤7
behaviour change techniques were more effective at improving adherence than
those employing >7.
PMID: 29911311
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
<https://www.ncbi.nlm.nih.gov/home/about/policies>.
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