Framework useful to identify barriers, facilitators to exercise for patients with OA

SEATTLE — The Theoretical Domains Framework was useful in the identification of barriers to exercise and facilitating factors of exercise for patients with osteoarthritis, according to research presented at the Osteoarthritis Research Society International World Congress on Osteoarthritis.

“Exercise adherence is not a problem patients can solve alone. Addressing each person’s individual situation and the barriers will [provide] the skills to help them want to exercise over the long term,” Philippa J. Nicolson, BPhty, said, here.

The Theoretical Domains Framework (TDF) was designed to identify 33 behavioral concepts across 14 domain and has demonstrated consistent validity, Nicolson said. For the study, researchers identified 4,054 patients with osteoarthritis (OA) through 23 eligible studies with data on aerobic, strengthening, flexibility, endurance, range of motion exercises or a combination of exercise types. The patients, who had hip or knee OA and were 45 years or older, responded to questions about intentional, supervised, unsupervised, prescribed or self-directed physical activity. Qualitative, quantitate and mixed method studies also were included in the study.

By applying the concepts from TDF, the researchers identified 101 barriers to exercise and 101 facilitators, which included variables such as the use of a walking aid, concerns about the rigidity of program or injury, time and cost. Most of the barriers identified focused on beliefs about capabilities and consequences, such as fear of further joint damage, Nicolson said.

Facilitators were often related to the environmental context and resources available, such as access to a pedometer, pain relief from aqua-based therapy or being offered incentives or medical advice.

Nicolson said the domains under which facilitators or barriers were seen were non-mutually exclusive. For example, the use of a walking aid could be a barrier or a facilitator depending on the context or individual perceptions. The TDF can be implemented by physicians to help reduce the barriers and potentially improve or increase intentional exercise for patients with OA, she said. - by Shirley Pulawski

Reference:

Nicolson PJ, et al. Paper #7. Presented at: Osteoarthritis Research Society International World Congress on Osteoarthritis. April 30-May 3, 2015; Seattle.

Disclosure: The researchers report no relevant financial disclosures.