INTERVENTIONS TO INCREASE ADHERENCE TO THERAPEUTIC EXERCISE IN OLDER ADULTS WITH LOW BACK PAIN AND/OR HIP/KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Review written by Dr Mariana Wingood info

BACKGROUND & OBJECTIVE

If low back pain (LBP) and hip/knee osteoarthritis (OA) are not managed well they can lead to disability. A key component of appropriate management is therapeutic exercise. Unfortunately, exercise adherence declines significantly among older adults, especially if they have pain. This is due to many pre-identified factors, including fear of movement and pain aggravation, time management, and uncertainty about benefits of exercise. This study systematically examined the effect of adherence interventions with the primary outcome being exercise adherence. As physical therapists, we can use this information to help our patients overcome exercise adherence barriers and improve their functional outcomes as well as their quality of life.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to complete this systematic review. With the assistance from a librarian the following databases were searched for literature: MEDLINE, CINAHL, SportDISCUS, Embase, and the Cochrane Library. Studies that met inclusion/exclusion criteria were assessed for quality using the Template for Intervention Description and Replication (TIDieR) checklist and the Cochrane Risk of Bias Tool. This was followed by data extraction and analysis.

RESULTS

A total of 9 articles were included in review. Effect size (Cohen's d) was used to quantify the difference between the control and adherence interventions. The effect size was classified into three categories: large (> 0.80), medium (0.50), and small

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