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Titre : | Understanding barriers to adherence to home exercise programs in patients with musculoskeletal neck pain (2023) |
Auteurs : | Peer Himler ; Griffin T. Lee ; Daniel I. Rhon ; Jodi L. Young ; Chad E. Cook ; Casey Rentmeester |
Type de document : | Article |
Dans : | Musculoskeletal Science and Practice (Vol. 63, February 2023) |
Article en page(s) : | 102722 |
Note générale : | https://doi.org/10.1016/j.msksp.2023.102722 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Adhésion et observance thérapeutiques ; Cervicalgie ; Douleur musculosquelettique ; Observance par le patient ; Techniques de physiothérapie |
Mots-clés: | Adhésion au programme d'exercice physique à domicile |
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. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S2468781223000073 |