肌肉骨骼疾病患者进行运动康复的障碍与促进因素：一项系统综述。

Barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions: A systematic review.

作者信息

de Amorim Hugo, de Noronha Marcos, Hunter Jayden, Barrett Stephen, Kingsley Michael

机构信息

La Trobe Rural Health School, La Trobe University, Bendigo, Australia; Holsworth Research Initiative, La Trobe University, Bendigo, Victoria, Australia.

La Trobe Rural Health School, La Trobe University, Bendigo, Australia.

出版信息

Musculoskelet Sci Pract. 2025 Jun;77:103279. doi: 10.1016/j.msksp.2025.103279. Epub 2025 Feb 5.

DOI:10.1016/j.msksp.2025.103279

PMID:40088807

Abstract

BACKGROUND

Exercise-based rehabilitation is the first line of treatment for people with musculoskeletal conditions. However, uptake and adherence are suboptimal, compromising the success of rehabilitation.

OBJECTIVES

To identify the barriers and facilitators that influence adherence to exercise-based rehabilitation in people with musculoskeletal conditions. Additionally, to identify the methods and instruments used to determine these barriers and facilitators.

DESIGN

Systematic review METHODS: Five databases from inception to May 2024 using terms related to exercise, musculoskeletal conditions, methods, barriers and facilitators. Risk of bias was assessed using either the Newcastle-Ottawa Scale or Cochrane risk of bias tool. Using an inductive thematic approach, barriers and facilitators were grouped into intrapersonal, interpersonal and community factors. Methods/instruments were categorized into three groups, being questionnaires, interviews and focus-groups.

RESULTS

Eighty-one of 8380 studies were included. The majority of studies were of good or fair quality (95%). The most frequently identified barriers were lack of time (53%), pain (45%) and health (40%). The most frequent facilitators were self-efficacy (42%), perceived health benefits (32%) and previous experiences (30%). The methods used were interviews (n = 53), questionnaires (n = 44) and focus groups (n = 10).

CONCLUSION

Most barriers and facilitators to exercise were related to intrapersonal factors. Although there is a lack of consistency in instruments used, the reported barriers and facilitators were similar across studies. Clinicians and researchers should consider intrapersonal factors when promoting exercise-based rehabilitation programs. Applying a theoretical framework to investigate barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions might assist practitioners to prioritize their practice.

摘要

背景

基于运动的康复治疗是肌肉骨骼疾病患者的一线治疗方法。然而，其接受度和依从性并不理想，影响了康复治疗的效果。

目的

确定影响肌肉骨骼疾病患者坚持基于运动的康复治疗的障碍和促进因素。此外，确定用于确定这些障碍和促进因素的方法和工具。

设计

系统评价

方法

检索五个数据库，时间范围从数据库建立至2024年5月，使用与运动、肌肉骨骼疾病、方法、障碍和促进因素相关的术语。使用纽卡斯尔-渥太华量表或Cochrane偏倚风险工具评估偏倚风险。采用归纳主题法，将障碍和促进因素分为个人因素、人际因素和社区因素。方法/工具分为三组，即问卷、访谈和焦点小组。

结果

8380项研究中有81项被纳入。大多数研究质量良好或中等（95%）。最常确定的障碍是时间不足（53%）、疼痛（45%）和健康状况（40%）。最常见的促进因素是自我效能感（42%）、感知到的健康益处（32%）和既往经验（30%）。使用的方法有访谈（n = 53）、问卷（n = 44）和焦点小组（n = 10）。