Abstract

BackgroundExercise programmes are frequently advocated for the management of musculoskeletal disorders; however, adherence is an important pre-requisite for their success. The assessment of exercise adherence requires the use of relevant and appropriate measures, but guidance for appropriate assessment does not exist. This research will identify and evaluate the quality and acceptability of all measures used to assess exercise adherence within a musculoskeletal setting, seeking to reach consensus for the most relevant and appropriate measures for application in research and/or clinical practice settings.Methods/designThere are two key stages to the proposed research. First, a systematic review of the quality and acceptability of measures used to assess exercise adherence in musculoskeletal disorders; second, a consensus meeting. The systematic review will be conducted in two phases and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure a robust methodology. Phase one will identify all measures that have been used to assess exercise adherence in a musculoskeletal setting. Phase two will seek to identify published and unpublished evidence of the measurement and practical properties of identified measures. Study quality will be assessed against the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. A shortlist of best quality measures will be produced for consideration during stage two: a meeting of relevant stakeholders in the United Kingdom during which consensus on the most relevant and appropriate measures of exercise adherence for application in research and/or clinical practice settings will be sought.DiscussionThis study will benefit clinicians who seek to evaluate patients’ levels of exercise adherence and those intending to undertake research, service evaluation, or audit relating to exercise adherence in the musculoskeletal field. The findings will impact upon new research studies which aim to understand the factors that predict adherence with exercise and which test different adherence-enhancing interventions. PROSPERO reference: CRD42013006212

Highlights

  • Exercise programmes are frequently advocated for the management of musculoskeletal disorders; adherence is an important pre-requisite for their success

  • The findings will impact upon new research studies which aim to understand the factors that predict adherence with exercise and which test different adherence-enhancing interventions

  • Adherence to therapeutic exercise is a pre-requisite for successful rehabilitation, yet its accurate measurement is challenging [11]

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Summary

Discussion

Adherence to therapeutic exercise is a pre-requisite for successful rehabilitation, yet its accurate measurement is challenging [11]. In clinical trials of exercise for musculoskeletal pain, adherence is not always measured, and when it is, the measures used are often not validated or standardised, making it difficult to compare the effectiveness of different interventions and impossible to pool data in the form of a meta-analyses [7,29]. This review will identify, summarise, and critically evaluate available measures of exercise adherence and develop recommendations about the most promising measures which are relevant for musculoskeletal research and clinical practice. This will benefit clinicians evaluating patients’ levels of exercise adherence and those intending to undertake research, service evaluation, or audit relating to exercise adherence in the musculoskeletal field. All authors read and approved the final manuscript

Background
27. Treuth MS
32. The PRISMA group
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