Lifestyle-based strategies ‘unlikely’ to improve exercise adherence in osteoarthritis
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Key takeaways:
- Changing strategies to increase exercise adherence may not be helpful in patients with osteoarthritis.
- Lower adherence to supervised exercise was linked to female sex and higher levels of education.
Strategies encouraging physical activity that are based on lifestyle, demographic, socioeconomic and disease-related factors are “unlikely” to improve exercise adherence among patients with osteoarthritis, according to data.
“Exercise positively affects body weight, lipid metabolism, glycemic control and systemic inflammation, preventing and treating OA-related chronic diseases,” Simone Battista, MSc, of Lund University, in Sweden, and colleagues wrote in Arthritis Care & Research. “Despite these benefits, adherence to exercise in OA is suboptimal.”
To investigate how certain factors, such as demographics and socioeconomic status, are linked to exercise adherence in patients with OA, Battista and colleagues conducted a cohort register-based study using data from the Swedish Osteoarthritis Registry on patients enrolled between 2012 and 2015. Data were collected on patients who began supervised exercise following enrollment and who were only registered in the cohort once.
Patient adherence was measured via “levels of adherence” to the supervised exercise sessions, the researchers wrote. Patents could be rated as demonstrating low, medium or high adherence, with high adherence referring to participating in 80% or more of the prescribed sessions. At the time of registration in the cohort, patients self-reported the included demographic and lifestyle characteristics. For socioeconomic data, factors such as education level and residential status were gathered from Statistics Sweden, the country’s government agency that provides population statistics.
The analysis included a total of 19,750 patients, of whom 5,862 (30%) recorded a low level of adherence, 3,947 (20%) recorded a medium level of adherence and 9,941 (50%) recorded a high level of adherence. According to the researchers, older age was associated with high levels of adherence (RRR = 1.01; 95% CI, 1.01-1.02), while female sex (RRR = 0.82; 95% CI, 0.75-0.89) and having a medium (RRR = 0.89; 95% CI, 0.81-0.98) or high (RRR = 0.84; 95% CI, 0.76-0.94) level of education were linked to low adherence levels. However, investigating factors could explain 1% of the variability in exercise adherence (R2 = 0.012), the researchers added.
“Strategies based on demographic and lifestyle, socioeconomic and disease-related factors are unlikely to improve exercise adherence significantly,” Battista and colleagues wrote. “Other elements, such as mindsets and contextual factors, need to be investigated.
“Moreover, as booster sessions, reminders, and behavioral-change techniques seem to improve exercise adherence, we should also understand how they motivate people to partake in exercise,” They added. “Considering the complexity of adherence and the types of treatments that have succeeded in improving it so far, there is a call for solutions that go beyond a one-size-fits-all approach, to accept human variability and uncertainty, and to foster tailored interventions for individuals.”
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