Abstract
Objectives
To identify measures of adherence to nonpharmacologic self-management treatments for
chronic musculoskeletal (MSK) populations; and to report on the measurement properties
of identified measures.
Data Sources
Five databases were searched for all study types that included a chronic MSK population,
unsupervised intervention, and measure of adherence.
Study Selection
Two independent researchers reviewed all titles for inclusion using the following
criteria: adult (>18y) participants with a chronic MSK condition; intervention, including
an unsupervised self-management component; and measure of adherence to the unsupervised
self-management component.
Data Extraction
Descriptive data regarding populations, unsupervised components, and measures of unsupervised
adherence (items, response options) were collected from each study by 1 researcher
and checked by a second for accuracy.
Data Synthesis
No named or referenced adherence measurement tools were found, but a total of 47 self-invented
measures were identified. No measure was used in more than a single study. Methods
could be grouped into the following: home diaries (n=31), multi-item questionnaires
(n=11), and single-item questionnaires (n=7). All measures varied in type of information
requested and scoring method. The lack of established tools precluded quality assessment
of the measurement properties using COnsensus-based Standards for the selection of
health Measurement INstruments methodology.
Conclusions
Despite the importance of adherence to self-management interventions, measurement
appears to be conducted on an ad hoc basis. It is clear that there is no consistency
among adherence measurement tools and that the construct is ill-defined. This study
alerts the research community to the gap in measuring adherence to self-care in a
rigorous and reproducible manner. Therefore, we need to address this gap by using
credible methods (eg, COnsensus-based Standards for the selection of health Measurement
INstruments guidelines) to develop and evaluate an appropriate measure of adherence
for self-management.
Keywords
List of abbreviations:
COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments), HCP (health care professional), MSK (musculoskeletal), WHO (World Health Organization)To read this article in full you will need to make a payment
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References
- Adherence to long-term therapies: evidence for action.World Health Organization, Geneva (Switzerland)2003
- Self-management education: history, definition, outcomes, and mechanisms.Ann Behav Med. 2003; 26: 1-7
- American College of Rheumatology 2012 recommendations for the use of nonpharmacological therapies in osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2012; 64: 465-474
- An updated overview of clinical guidelines for the management of non-specific low back pain in primary care.Eur Spine J. 2010; 19: 2075-2094
- 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
- Adherence to rehabilitation in patients with low back pain.Man Ther. 2003; 8: 110-116
- Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults.Cochrane Database Syst Rev. 2010; : CD005956
- Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.Qual Life Res. 2012; 21: 651-657
- Effect of neck exercise on sitting posture in patients with chronic neck pain.Phys Ther. 2007; 87: 408-417
- A randomized controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain.Clin J Pain. 2005; 21: 463-470
- Effects of home strength training and stretching versus stretching alone after lumbar disk surgery: a randomized study with a 1-year follow-up.Arch Phys Med Rehabil. 2005; 86: 865-870
- The effect of a rehabilitation exercise program on head repositioning accuracy and reported levels of pain in chronic neck pain subjects.Journal of Whiplash and Related Disorders. 2002; 1: 99-112
- Enhancing function in older adults with chronic low back pain: a pilot study of endurance training.Arch Phys Med Rehabil. 2003; 84: 1324-1331
- Managing chronic nonspecific low back pain with a sensorimotor retraining approach: exploratory multiple-baseline study of 3 participants.Phys Ther. 2011; 91: 535-546
- Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain.Spine (Phila Pa 1976). 2009; 34: 2066-2076
- Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients.Arch Phys Med Rehabil. 2004; 85: 823-832
- TTM-based counselling in physiotherapy does not contribute to an increase of adherence to activity recommendations in older adults with chronic low back pain–a randomised controlled trial.Eur J Pain. 2007; 11: 31-37
- Combined exercise and motivation program: effect on the compliance and level of disability of patients with chronic low back pain: a randomized controlled trial.Arch Phys Med Rehabil. 1998; 79: 475-487
- Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain.Spine (Phila Pa 1976). 2005; 30: 995-1000
- Multilevel lumbar fusion and postoperative physiotherapy rehabilitation in a patient with persistent pain.Physiother Theory Pract. 2011; 27: 238-245
- Motivational enhancement therapy in addition to physical therapy improves motivational factors and treatment outcomes in people with low back pain: a randomized controlled trial.Arch Phys Med Rehabil. 2011; 92: 176-183
- Loving-kindness meditation for chronic low back pain: results from a pilot trial.J Holist Nurs. 2005; 23: 287-304
- Characteristics and predictors of short-term outcomes in individuals self-selecting yoga or physical therapy for treatment of chronic low back pain.PM R. 2010; 2: 1006-1015
- Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study.Clin Rehabil. 2008; 22: 592-600
- Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.J Psychosom Res. 2010; 68: 29-36
- Effects of twelve-month strength training subsequent to twelve-month stretching exercise in treatment of chronic neck pain.J Strength Cond Res. 2006; 20: 304-308
- The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain.Sleep Med. 2010; 11: 302-309
- [Effectiveness and compliance to a center-based short rehabilitation program with a home-based program for chronic low back pain].Ann Readapt Med Phys. 2002; 45 ([French]): 265-272
- The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain.Man Ther. 2009; 14: 696-701
- The effects of mode of exercise instruction on compliance with a home exercise program in older adults with osteoarthritis.Physiotherapy. 2005; 91: 79-86
- Comparing yoga, exercise and a self-care book for chronic low back pain.Ann Intern Med. 2005; 143: 849-856
- Cognitive behavioural components in physiotherapy management of chronic whiplash associated disorders (WAD)–a randomized group study.Physiother Theor Pract. 2001; 17: 229-238
- The effect of a Mensendieck exercise program as secondary prophylaxis for recurrent low back pain.Spine (Phila Pa 1976). 1999; 24 (discussion 1592): 1585-1591
- A home based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study.J Am Geriatric Soc. 2003; 51: 387-392
- Active neck muscle training in the treatment of chronic neck pain in women.JAMA. 2003; 289: 2509-2516
- Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomized controlled trial.BMJ. 2003; 327: 475
- Supplementation of general endurance with stabilization training versus general exercise only physiological and functional outcomes of a randomized controlled trial of patients with recurrent low back pain.Clin Biomech. 2006; 20: 474-482
- A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis.JAMA. 1997; 277: 25-31
- Compliance to exercise therapy in older participants with knee osteoarthritis: implications for treating disability.Med Sci Sports Exerc. 1997; 29: 977-985
- 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
- In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial.Aust J Physiother. 2007; 53: 155-160
- Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints.Patient Educ Couns. 2006; 61: 117-125
- Yoga for veterans with chronic low-back pain.J Altern Complement Med. 2008; 14: 1123-1129
- The reduction of chronic, nonspecific low back pain through the control of early morning lumbar flexion: 3-year follow-up.J Occup Rehabil. 2002; 12: 13-19
- The clinical effects of intensive, specific exercise on chronic low back pain: a controlled study of 895 consecutive patients with 1-year follow up.Orthopedics. 1995; 18: 971-981
- Long-term outcomes of an arthritis self-management programme.Brit J Rheumatol. 1998; 37: 1315-1319
- The long term outcome of the back school in patients with chronic mechanical low back pain.J Back Musculoskelet Rehabil. 2004; 17: 83-89
- Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study.Arch Phys Med Rehabil. 2009; 90: 1734-1739
- Long-term exercise adherence after intensive rehabilitation for chronic low back pain.Med Sci Sports Exerc. 2000; 32: 551-557
- Long-term impact of fit and strong: on older adults with osteoarthritis.Gerontologist. 2006; 46: 801-814
- Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee.Arthritis Care Res. 2010; 62: 1087-1094
- The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain: a follow-up study.Spine (Phila Pa 1976). 2000; 25: 1809-1816
- A controlled study on the outcome of inpatient and outpatient treatment of low back pain. Part III. Long term follow-up of pain disability and compliance.Scan J Rehabil Med. 1990; 22: 182-188
- Effects of spousal control and support on older adults’ recovery from knee surgery.J Fam Psychol. 2006; 20: 302-310
- Health education for hypertensive patients.JAMA. 1979; 241: 1700-1703
- Concurrent and predictive validity of a self-reported measure of medication adherence.Med Care. 1986; 24: 67-74
- Medication compliance in a family practice.Can Fam Physician. 1992; 38: 2333-2337
- Construct validity and interrater agreement of the sport injury rehabilitation adherence scale.J Sport Rehabil. 2002; 11: 170-178
- The Sport Injury Rehabilitation Adherence Scale: a reliable scale for use in clinical physiotherapy.Physiotherapy. 2007; 93: 17-22
- The Medical Outcomes Study. An application of methods for monitoring the results of medical care.JAMA. 1989; 262: 925-930
- Measurement in medicine: a practical guide.Cambridge Univ Pr, New York2011
Article info
Publication history
Published online: August 06, 2014
Footnotes
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.