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Does a web-based exercise programming system improve home exercise adherence for people with musculoskeletal conditions? Randomized controlled trial

Bennell, Kim L. BAppSci (Physio), PhD1; Marshall, Charlotte J. BSc (Hons), PGDipPhty, MPhty1; Dobson, Fiona BAppSci (Physio), PhD1; Kasza, Jessica B Sci (Hons), PhD2; Lonsdale, Chris BSc (Hons), MA, PhD3; Hinman, Rana S. BPhysio (Hons), PhD1

American Journal of Physical Medicine & Rehabilitation: April 22, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001204
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Objective 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 randomised to: 1) control (home exercise prescribed by therapist’s usual methods), or 2) 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 (NRS). 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 NRS units (95% confidence intervals): adherence overall -1.0 (-1.6,-0.3) and regarding number of exercises in session -0.7 (-1.3,-0.1), number of repetitions -0.8 (-1.4,-0.2) and number of sessions -1.0 (-1.6,-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.

1 Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Victoria, Australia.

2 Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia

3 Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, New South Wales, Australia

Corresponding author: Dr Kim Bennell, Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, 3010. ph: + 61 3 83444135, email: k.bennell@unimelb.edu.au

Authors Disclosures: This trial was funded by the National Health and Medical Research Council (NHMRC, 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 nor in the interpretation of the findings. KLB is funded by a NHMRC Principal Research Fellowship (#1058440). RSH is funded by an Australian Research Council Future Fellowship (FTFT0991413). KB previously received funds as a consultant for Physitrack®.

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