Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Bonsall Street, M15 6GX, Manchester, United Kingdom.
Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
J Bodyw Mov Ther. 2023 Jan;33:95-105. doi: 10.1016/j.jbmt.2022.09.014. Epub 2022 Sep 26.
Adherence to exercise interventions is the cornerstone of a successful rehabilitation program. However, there is limited evidence on multifaceted components of exercise adherence. Therefore, we aimed to summarize the existing literature on measurement, determinants, barriers, theoretical frameworks, and evidence-based interventions that support exercise adherence.
We conducted a scoping review based on the PRISMA extension for scoping reviews guidelines and searched the literature in PubMed, Cochrane Databases of Systematic Reviews, ScienceDirect, and Web of Science. Two reviewers independently screened articles. The included articles were subjected to data extraction and qualitative synthesis.
A total of 72 articles were included for this review. Data synthesis showed that there are no gold standard methods of measuring exercise adherence; however, questionnaires and daily logs are commonly used tools. The determinants of adherence are personal, disease-related, therapy-related, provider-related, and health system-related. The common barriers to adherence are the absence of a caregiver, low health literacy, poor communication by healthcare providers, cost, and lack of access to health facilities. Few evidence-based interventions used for supporting adherence are behavioral strategies, improving self-efficacy, motivational therapy, and mHealth or multimedia.
Non-adherence to exercises is a challenge for healthcare providers. There are no standard guidelines for the evaluation and management of non-adherence to exercises. Future studies should aim at developing objective measures of exercise adherence and investigate the long-term effects of adherence strategies in different disease populations. It is an under-researched area and requires multipronged strategies to improve adherence levels among patients.
坚持运动干预是康复计划成功的基石。然而，关于运动坚持的多方面因素的证据有限。因此，我们旨在总结关于运动坚持的测量、决定因素、障碍、理论框架和循证干预的现有文献。
我们根据 PRISMA 扩展的范围综述指南进行了一项范围综述，并在 PubMed、Cochrane 系统评价数据库、ScienceDirect 和 Web of Science 中搜索文献。两位评审员独立筛选文章。纳入的文章进行了数据提取和定性综合。
共有 72 篇文章纳入本综述。数据综合表明，目前没有衡量运动坚持的黄金标准方法；然而，问卷和日常日志是常用的工具。坚持的决定因素包括个人、疾病相关、治疗相关、提供者相关和卫生系统相关。坚持的常见障碍是缺乏照顾者、健康素养低、医疗保健提供者沟通不佳、成本高以及缺乏获得卫生设施的机会。用于支持坚持的少数循证干预措施是行为策略、提高自我效能、动机疗法以及移动健康或多媒体。
不坚持运动是医疗保健提供者面临的挑战。目前还没有评估和管理不坚持运动的标准指南。未来的研究应旨在开发运动坚持的客观测量方法，并研究不同疾病人群中坚持策略的长期效果。这是一个研究不足的领域，需要采取多管齐下的策略来提高患者的坚持水平。
