Interventions such as supervised or individualized exercise therapy and self-management techniques may enhance exercise adherence, say authors of a systematic review that assessed the effects of interventions to improve exercise adherence for people with chronic musculoskeletal pain (CMP). However, the authors add, high-quality, randomized trials with long-term follow up that explicitly address adherence to exercises and physical activity are needed and a standard validated measure of exercise adherence should be used consistently in future studies. The review was published January 20 in The Cochrane Database of Systematic Reviews (2010, Issue 2).
Researchers searched the trials registers of relevant Cochrane Review Groups, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Science Citation Index, Social Science Citation Index, and reference lists of articles to October 2007. They also consulted experts for unpublished trials. Selection criteria included research that evaluated interventions that aimed to improve adherence to exercise and physical activity in adults with pain for 3 months and over. Researchers contacted study authors for missing information.
The review included 42 trials with 8,243 participants, mainly with osteoarthritis and spinal pain. Two of the 17 trials that compared different types of exercise showed positive effects, suggesting that the type of exercise is not an important factor in improving exercise adherence. Six trials studied different methods of delivering exercise, such as supervising exercise sessions, refresher sessions, and audio or videotapes of the exercises to take home. Of these, five trials found interventions improved exercise adherence. Four trials evaluated specific interventions targeting exercise adherence; three of these showed a positive effect on exercise adherence. In eight trials studying self-management programs, six improved adherence measures. One trial found that graded activity was more effective than usual care for improving exercise adherence. Cognitive behavioral therapy was effective in a trial in people with whiplash-associated disorder, but not in trials of people with other CMP. In the trials that showed a positive effect on adherence, association between clinical outcomes and exercise adherence was conflicting.
In countless research studies, the advantages of exercise have been proven. Contact any of the PTs at ECRC Physical Therapy to help YOU find an exercise program that works and that you will adhere to.
ECRC Physical Therapy offers a FIT 4 U program, that helps you find the most appropriate exercise for you, whether you are just starting to exercise or trying to take minutes off your time at the Boston Marathon. Call any of our offices to learn more.
Do you have a Nintendo Wii? If so, contact Cindy Knight, PTMSOCS in the Killingly office to learn how you can maximize the Wii to your benefit and modify exercises to strengthen most appropriately for you.