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Does a Web-Based Exercise Programming System Improve Home Exercise Adherence for People With Musculoskeletal Conditions?

A Randomized Controlled Trial

Bennell, Kim L. BAppSci (Physio), PhD; Marshall, Charlotte J. BSc (Hons), GDipPhty, MPhty; Dobson, Fiona BAppSci (Physio), PhD; Kasza, Jessica B Sci (Hons), PhD; Lonsdale, Chris BSc (Hons), MA, PhD; Hinman, Rana S. BPhysio (Hons), PhD

American Journal of Physical Medicine & Rehabilitation: October 2019 - Volume 98 - Issue 10 - p 850–858
doi: 10.1097/PHM.0000000000001204
Original Research Articles

Objective The aim of the study was to evaluate whether a web-based exercise programming system improves adherence to a home exercise program for people with musculoskeletal conditions.

Design Eligible patients with a musculoskeletal condition presenting to a physical therapist in private practice were randomized to the following: (a) control (home exercise prescribed by therapist’s usual methods) or (b) intervention (home exercise prescribed using a web-based exercise programming system). The primary outcome was self-rated exercise adherence measured at week 3 via 11-point Numeric Rating Scales. Secondary outcomes were satisfaction with exercise delivery and confidence in ability to undertake prescribed exercise. Process measures were also included.

Results We enrolled 305 participants, with loss to follow-up of 14.5% (22/152) and 13.7% (21/153) in intervention and control groups, respectively. Compared with controls, the intervention group reported higher exercise adherence (mean difference Numeric Rating Scale units (95% confidence intervals): adherence overall −1.0 [−1.6 to −0.3] and regarding number of exercises in session −0.7 [−1.3 to −0.1], number of repetitions −0.8 [−1.4 to −0.2], and number of sessions −1.0 [−1.6 to −0.3]). The intervention group showed greater confidence to exercise than control, with no difference in satisfaction.

Conclusions A web-based exercise programming system improved home exercise adherence and confidence in ability to undertake exercise, although the clinical relevance of the results needs to be established.

From the Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Victoria, Australia (KLB, CJM, FD, RSH); Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia (JK); and Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, New South Wales, Australia (CL).

All correspondence should be addressed to: Kim L. Bennell, BAppSci (Physio), PhD, Department of Physiotherapy, The University of Melbourne, 161 Barry St, Carlton, Victoria, 3053, Australia.

This study was supported by the National Health and Medical Research Council (National Health and Medical Research Council, Program Grant #631717). Physitrack provided use of the program as well as iPads for the physical therapists. Neither the funder nor Physitrack had any role in the collection or analysis of the data or in the interpretation of the findings. KLB is funded by a National Health and Medical Research Council Principal Research Fellowship (#1058440). RSH is funded by an Australian Research Council Future Fellowship (FTFT0991413). KLB previously received funds as a consultant for Physitrack.

KLB, FD, and RSH conceived the project and KLB led the trial. KLB procured the project funding. KLB, FD, CJM, CL, and RSH developed the protocol. CJM co-ordinated the trial and recruited the physical therapists. KLB wrote the first and final draft of this article. All authors provided feedback on drafts of this article and read and approved the article.

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Online date: April 23, 2019

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