Level of adherence to prescribed exercise in spondyloarthritis and factors affecting this adherence: a systematic review

McDonald, M.T., Siebert, S. , Coulter, E.H. , McDonald, D.A. and Paul, L. (2019) Level of adherence to prescribed exercise in spondyloarthritis and factors affecting this adherence: a systematic review. Rheumatology International, 39(2), pp. 187-201. (doi: 10.1007/s00296-018-4225-8) (PMID:30649569) (PMCID:PMC6513902)

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Adherence is a primary determinant of the effectiveness of any intervention. Exercise is considered essential in the management of spondyloarthritis (SpA); however, the overall adherence to exercise programmes and factors affecting adherence are unknown. The aim of this systematic review was to examine measures of, and factors influencing adherence to, prescribed exercise programmes in people with SpA. A search was performed in August 2018 using five data bases; the Cochrane library, CINAHL, EMBASE, MEDLINE, and Web of Science Collections. Inclusion criteria were: studies with adults (> 18 years) with SpA, with a prescribed exercise intervention or educational programme with the aim of increasing exercise participation. Article quality was independently assessed by two assessors. Extracted descriptive data included: populations, interventions, measures of adherence and factors affecting adherence. Percentage adherence rates to prescribed exercises were calculated if not reported. Nine studies were included with a total of 658 participants, 95% of participants had a diagnosis of ankylosing spondylitis. Interventions and measurement of adherence varied, making comparisons difficult. Rates of adherence ranged from 51.4 to 95%. Single studies identified; adherence improved following educational programmes, and higher disease severity and longer diagnostic delays were associated with higher adherence. Conflicting evidence was found as to whether supervision of exercise improved adherence. Three consecutive studies demonstrated adherence reduced over time. Adherence to prescribed exercise in SpA was poorly reported and predominately for people with AS. The levels of adherence and factors affecting prescribed exercise in SpA remain unclear. Future research should measure adherence across a longer time period and investigate possible factors which may influence adherence.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Coulter, Dr Elaine and Paul, Dr Lorna and McDonald, Marie and Siebert, Professor Stefan
Authors: McDonald, M.T., Siebert, S., Coulter, E.H., McDonald, D.A., and Paul, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Rheumatology International
ISSN (Online):1437-160X
Published Online:16 January 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Rheumatology International 39(2):187-201
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
685431WEB-based Physiotherapy for people with Axial Spondyloarthritis (WEB-PASS) - a cohort StudyLorna PaulArthritis Research UK (ARTRESUK)20874SM - NURSING & HEALTHCARE