Evidence suggests that to facilitate physical activity sedentary people may adhere to one component of exercise prescriptions (intensity, duration or frequency) without adhering to other components. Some experts have provided evidence for determinants of adherence to different components among healthy people. However, our understanding remains scarce in this area for patients with neck or low back pain. The aims of this study are to determine whether patients with neck or low back pain have different rates of adherence to exercise components of frequency per week and duration per session when prescribed with a home exercise program, and to identify if adherence to both exercise components have distinct predictive factors.
The aim of this study is to explore perceptions of people with chronic neck or low back pain about how characteristics of home exercise programs and care-provider style during clinical encounters may affect adherence to exercises.
1 April 2009 in Journal of Rehabilitation Medicine
To identify the beliefs and perceptions of patients with chronic neck and low back pain that influence adherence to home exercise during exacerbation and/or remission of pain. Qualitative study using a focus group technique. Thirty-four patients (23 women, age range 26-70 years) with chronic neck or low back pain who had participated in a home exercise programme. Seven focus groups were formed. Participants were sampled purposefully from all patients with chronic neck or low back pain who attended for physiotherapy at 4 primary healthcare centres. Patients were interviewed about how they perceived their adherence to a home exercise programme during chronic pain. Data were analysed using a phenomenographic method. Several themes about patients' beliefs and perceptions were identified as factors related to adherence. These factors change when pain or disabilities appear, decrease or disappear for an extended period. Beliefs about illness and treatment are more likely when pain is present and when pain disappears for an extended period. However, patients consider perceptions about barriers, social support and physical environment when pain decreases. These findings may represent an important potential for improving the adherence of patients with chronic pain to home exercise programmes.
Many families have problems adhering to home exercise programs (HEP) for children with developmental disabilities. However, parental participation in HEP is known to have a positive effect on child-related outcome variables, as well as on parental functioning. This study examined whether the different behaviours of health professionals, and the behaviour and social characteristics of parents determine rates of parental adherence to both the frequency per week, and duration per session, of HEP for children with developmental disabilities attending paediatric services in early intervention centres. In this study, developmental disabilities include those caused by developmental delay or specific health conditions such as cerebral palsy, congenital illness, or others. Survey. Eighteen early intervention centers. Parents of children with developmental disabilities receiving HEP. A self-reported questionnaire was used to examine: whether frequency and duration of weekly exercise sessions was prescribed by physiotherapists; whether the child had received the HEP according to what was prescribed; and items related to the individual, social support, illnesses and the involvement of the health professional. Multiple logistic regression analyses examined their relative relevance. In this study 219 parents participated. The rate of adherence to the prescribed frequency and duration of the HEP was similar (61.4-57.2%). The probability of adherence to both components increased for parents who had a low perception of the existence of barriers for integrating the exercises into their daily routine (OR=2.62 and 4.83). Furthermore, other cognitive factors of parents had a variable influence. The involvement of the professional had a significant impact regarding the frequency of the HEP. Professional involvement increased the probability of exercises being followed accurately by adopting strategies such as: providing information about the progress and evolution of the exercises (OR=3.75); justifying their usefulness (OR=2.17); giving advice on how to include them into the daily routine (OR=2.54); checking skills during follow-up (OR=2.21) and asking about home adherence (OR=2.20). Providing information during clinical encounters, advising how to include exercises into the daily routine, and checking skills and adherence during follow-up represent practical targets for clinicians aiming to improve the frequency of HEP for children with developmental disabilities. This study contributes to the knowledge of physicians and therapists regarding how their interventions (in particular, information, instructions for HEP and follow-up) influence parents regarding their adherence to HEP.
Ergonomic supports have become popular for the prevention of musculoskeletal disorders. This study sought to evaluate the efficacy of different ergonomic supports and their combination to reduce muscle activity of the neck and shoulder muscles. A one-way repeated measures design was used to evaluate 36 practicing dentists while they performed three posterior composite restoration procedures on a phantom head. Portable surface electromyography (sEMG) recordings were used to measure the muscle activity of three muscles (Upper Trapezius, Lateral Deltoid and Anterior Deltoid) in the dominant upper extremity, with and without the use of different ergonomic supports (ergonomic stool, magnification lenses and both) during the performance of these tasks. A repeated measures analysis of variance was used. The muscle activity of all muscles differed significantly across the four ergonomic conditions during the three tasks. The use of ergonomic supports such as magnification lenses, the ergonomic stool, or the combination of both, is effective for decreasing the muscle activity of the three muscles during the three tasks, when compared to standard practice. In addition, the decrease of muscle activity was higher using magnification lenses when compared to the ergonomic stool. Furthermore, the greatest decrease was found with the combination of both supports.