Interventions to achieve ongoing exercise adherence for adults with chronic health conditions who have completed a supervised exercise program: systematic review and meta-analysis

Abstract

Objective:

To determine which exercise adherence interventions are most effective for achieving ongoing exercise adherence in adults with chronic health conditions who had already completed a supervised short-term program.

Method:

Search of MEDLINE (Ovid Medline 1946 to April 8^th, 2016), EMBASE (1980 to April 8^th, 2016), CINAHL (1982-April 8^th 2016) and the Cochrane Central Register of Controlled Trials was conducted. The chronic health conditions search terms as per the Chronic Disease and Participation in Work AIHW Report, 2008. Included were randomised (or quasi-randomised) trials and observational studies evaluating interventions that aimed to improve exercise adherence in adults with chronic health conditions that had completed a supervised exercise program. Random-effects meta-analyses and random-effects logistic meta-regression were used to examine relationships between exercise adherence strategy and adherence.

Results:

Eleven studies were included with a total of 1231 participants with Chronic Obstructive Pulmonary Disease, Diabetes, Cardiovascular disease or Osteoarthritis. Methods used for maintaining adherence were categorized post hoc as: centre based programs; home exercise programs with telephone follow-up; home exercise programs with no follow-up; and weaning programs that transitioned patients to an independent, off-site exercise program.

There was no difference in the proportion of participants who were fully adherent to an exercise program 12 months between the centre-based follow-up (pooled proportion fully adherent=0.34) and telephone follow-up (pooled proportion fully adherent=0.30, difference p-value=0.75).

Conclusion:

Interventions such as centre-based exercise programs or home exercise programs (with or without telephone follow-up) do not differentially impact exercise adherence for people who have completed a short-term supervised program.

Keywords

Chronic disability exercise meta-analysis systematic review

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References

Statistics ABo. Physical activity in Australia: a snapshot, 2004–05. ABS Canberra, Australia, 2011.

Cambach

Wagenaar

Koelman

van Keimpema

Kemper

. The long-term effects of pulmonary rehabilitation in patients with asthma and chronic obstructive pulmonary disease: a research synthesis. Archives of physical medicine and rehabilitation. 1999; 80: 103–111.

Griffiths

Burr

Campbell

, et al. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. The Lancet. 2000; 355: 362–368.

Singh

Smith

Hyland

Morgan

. A short outpatient pulmonary rehabilitation programme: immediate and longer term effects on exercise performance and quality of life. Respiratory medicine. 1998; 92: 1146–1154.

Castaneda

Layne

Munoz-Orians

, et al. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes care. 2002; 25: 2335–2341.

Maiorana

O’Driscoll

Goodman

Taylor

Green

. Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes research and clinical practice. 2002; 56: 115–123.

Hughes

Seymour

Campbell

Desai

Huber

Chang

. Fit and strong!: Bolstering maintenance of physical activity among older adults with lower-extremity osteoarthritis. Am J Health Behav. 2010; 34: 750–763.

Ades

Waldmann

McCann

Weaver

. Predictors of cardiac rehabilitation participation in older coronary patients. Archives of Internal Medicine. 1992; 152: 1033–1035.

Brooks

Krip

Mangovski-Alzamora

Goldstein

. The effect of postrehabilitation programmes among individuals with chronic obstructive pulmonary disease. Eur Respir J. 2002; 20: 20–29.

10.

Sherrington

Tiedemann

Fairhall

Lord

. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. New South Wales public health bulletin. 2011; 22: 78–83.

11.

Beauchamp

Evans

Janaudis-Ferreira

Goldstein

Brooks

. Systematic review of supervised exercise programs after pulmonary rehabilitation in individuals with COPD. CHEST Journal. 2013; 144: 1124–1133.

12.

Dunstan

Vulikh

Owen

Jolley

Shaw

Zimmet

. Community center-based resistance training for the maintenance of glycemic control in adults with type 2 diabetes. Diabetes care. 2006; 29: 2586–25891.

13.

Teychenne

Ball

Salmon

, et al. Adoption and maintenance of gym-based strength training in the community setting in adults with excess weight or type 2 diabetes: a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2015; 12: 105.

14.

Higgins

Altman

Sterne

. Assessing risk of bias in included studies. In: Higgins

JPT

Green

(eds) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011.

15.

Ries

Kaplan

Myers

Prewitt

. Maintenance after pulmonary rehabilitation in chronic lung disease: a randomized trial. American journal of respiratory and critical care medicine. 2003; 167: 880–888.

16.

Spencer

Alison

McKeough

. Maintaining benefits following pulmonary rehabilitation: a randomised controlled trial. Eur Respir J. 2010; 35: 571–577.

17.

Cockram

Cecins

Jenkins

. Maintaining exercise capacity and quality of life following pulmonary rehabilitation. Respirology. 2006; 11: 98–104.

18.

Beauchamp

Francella

Romano

Goldstein

Brooks

. A novel approach to long-term respiratory care: Results of a community-based post-rehabilitation maintenance program in COPD. Respiratory Medicine. 2013; 107: 1210–1216.

19.

Berry

Rejeski

Adair

Ettinger

Zaccaro

Sevick

. A randomized, controlled trial comparing long-term and short-term exercise in patients with chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation and Prevention. 2003; 23: 60–68.

20.

Roessler

Ibsen

. Promoting exercise on prescription: Recruitment, motivation, barriers and adherence in a Danish community intervention study to reduce type 2 diabetes, dyslipidemia and hypertension. Journal of Public Health. 2009; 17: 187–193.

21.

White

Thomas

. Standardized mean differences in individually-randomized and cluster-randomized trials, with applications to meta-analysis. Clinical Trials. 2005; 2: 141–151.

22.

Lee

D-CA

Pritchard

McDermott

Haines

. Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis. Health Education Journal. 2014; 73: 530–544.

23.

Agresti

Coull

. Approximate is better than “exact” for interval estimation of binomial proportions. The American Statistician. 1998; 52: 119–126.

24.

Ringbaek

Brøndum

Martinez

Thøgersen

Lange

. Long-term Effects of 1-Year Maintenance Training on Physical Functioning and Health Status in Patients With COPD: A Randomized Controlled Study. Journal of cardiopulmonary rehabilitation and prevention. 2010; 30: 47–52.

25.

Carlson

Johnson

Franklin

VanderLaan

. Program participation, exercise adherence, cardiovascular outcomes, and program cost of traditional versus modified cardiac rehabilitation. The American journal of cardiology. 2000; 86: 17–23.

26.

Elliott

Watson

Wilkinson

Musk

Lake

. Short-and long-term hospital and community exercise programmes for patients with chronic obstructive pulmonary disease. Respirology. 2004; 9: 345–351.

27.

Higgins

Thompson

Deeks

Altman

. Measuring inconsistency in meta-analyses. BMJ: British Medical Journal. 2003; 327: 557.

28.

Clark

. Identifying psychological, physiological, and environmental barriers and facilitators to exercise among older low income adults. Journal of Clinical Geropsychology. 1999; 5: 51–62.

29.

Hirvensalo

Lampinen

Rantanen

. Physical exercise in old age: An eight-year follow-up study on involvement, motives, and obstacles among persons age 65–84. Journal of Aging and Physical Activity. 1998; 6: 157–168.

30.

McAuley

Jerome

Elavsky

Marquez

Ramsey

. Predicting long-term maintenance of physical activity in older adults. Preventive medicine. 2003; 37: 110–118.

31.

Ashworth

Chad

Harrison

Reeder

Marshall

. Home versus center based physical activity programs in older adults. The Cochrane Library, 2005.

32.

Burbank

Riebe

. Promoting exercise and behavior change in older adults: interventions with the transtheoretical model. New York: Springer, 2001.

33.

McPherson

. Sociocultural perspectives on aging and physical activity. JAPA. 2010; 2.

34.

Safran

Taira

Rogers

Kosinski

Ware

Tarlov

. Linking primary care performance to outcomes of care. The Journal of family practice. 1998; 47: 213–220.

35.

Australian Insitute of Health and Welfare. Chronic disease and participation in work. Canberra: Australian Institute of Health and Welfare, 2009.

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