Conceptualising adherence to exercise for musculoskeletal pain: A concept mapping study. (26th December 2022)

• Record Type: Journal Article
• Authors: Bailey, Daniel; Bishop, Annett; Foster, Nadine E.; Holden, Melanie A.
• Is Part Of: Physiotherapy research international. Volume 28:Number 2(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-26
• Subjects: exercise -- musculoskeletal -- pain -- outcome measures; Physical therapy -- Periodicals; Physical Therapy Modalities -- Periodicals; Physiothérapie -- Périodiques; 615.82
• DOI: 10.1002/pri.1989
• Languages: English
• ISSNs: 1358-2267

Abstract

Abstract: Background: The concept of adherence to exercise for musculoskeletal (MSK) pain is poorly defined and inadequately measured. This study aimed to, (1) conceptualise adherence to exercise therapy for MSK pain, and (2) identify statements most representative of the new conceptualisation that could be developed into items for a new measurement tool. Methods: Concept mapping methodology was used, which is an integrated mixed methods approach. Focus groups with stakeholders generated statements describing adherence to exercise for MSK pain. Statements were grouped according to themes and rated for importance. Data analysis via multidimensional scaling and hierarchical cluster analysis produced a series of concept maps, which were refined during a further stakeholder workshop to produce the final conceptualisation of exercise adherence. Mean importance ratings established statements most suitable for future development. Results: Twenty‐eight participants produced 100 unique statements concerning adherence, which were sorted and rated. Analysis of the sort data with further participant refinement concluded that adherence to exercise consists of six domains: communication with experts; targets; how exercise is prescribed; patient knowledge and understanding; motivation and support; and psychological approach and attitudes. Fifty‐six statements were rated with above average importance for inclusion in a new measure of adherence to exercise for MSK pain. Conclusion: Adherence to exercise for MSK pain is a complex and multi‐dimensional construct represented by six distinct domains. Statements that best represent these domains have been identified by key stakeholders and will inform the development of a new measure of adherence to exercise for MSK pain. Key points: Patient adherence is likely an important determinant in the effectiveness of exercise recommendations for musculoskeletal (MSK) pain. However, exercise adherence for MSK pain is currently poorly conceptualised. As such, exercise adherence cannot currently be measured reliably or validly. This study conceptualised adherence to exercise for MSK pain from the perspective of relevant stakeholders (patients, physiotherapists, and researchers). It was found to have six distinct domains: communication with experts; targets; how exercise is prescribed; patient knowledge and understanding; motivation and support; and psychological approach and attitudes. Fifty‐six statements that best describe the six domains of exercise adherence from the perspective of stakeholders were identified for future development into a new measure of exercise adherence.