Factors Associated With Adherence to a Supervised Exercise Intervention for Osteoarthritis: Data From the Swedish Osteoarthritis Registry

Battista, Simone; Kiadaliri, Ali; Jönsson, Thérése; Gustafsson, Kristin; Englund, Martin; Testa, Marco; Dell'Isola, Andrea

Abstract

Objective. To explore how lifestyle and demographic, socioeconomic, and disease-related factors are associated with supervised exercise adherence in an osteoarthritis (OA) management program and the ability of these factors to explain exercise adherence. Methods. A cohort register-based study on participants from the Swedish Osteoarthritis Registry who attended the exercise part of a nationwide Swedish OA management program. We ran a multinomial logistic regression to determine the association of exercise adherence with the abovementioned factors. We calculated their ability to explain exercise adherence with the McFadden R 2. Results. Our sample comprises 19,750 participants (73% female, mean ± SD age 67 ± 8.9 years). Among them, 5,862 (30%) reached a low level of adherence, 3,947 (20%) a medium level, and 9,941 (50%) a high level. After a listwise deletion, the analysis was run on 16,685 participants (85%), with low levels of adherence as the reference category. Some factors were positively associated with high levels of adherence, such as older age (relative risk ratio [RRR] 1.01 [95% confidence interval (95% CI) 1.01-1.02] per year), and the arthritis-specific self-efficacy (RRR 1.04 [95% CI 1.02-1.07] per 10-point increase). Others were negatively associated with high levels of adherence, such as female sex (RRR 0.82 [95% CI 0.75-0.89]), having a medium (RRR 0.89 [95% CI 0.81-0.98] or a high level of education (RRR 0.84 [95% CI 0.76-0.94]). Nevertheless, the investigating factors could explain 1% of the variability in exercise adherence (R 2 = 0.012). Conclusion. Despite the associations reported above, the poorly explained variability suggests that strategies based on lifestyle and demographic, socioeconomic, and disease-related factors are unlikely to improve exercise adherence significantly.

Citation

Battista, S., Kiadaliri, A., Jönsson, T., Gustafsson, K., Englund, M., Testa, M., & Dell'Isola, A. (2023). Factors Associated With Adherence to a Supervised Exercise Intervention for Osteoarthritis: Data From the Swedish Osteoarthritis Registry. Arthritis Care and Research, 75(10), 2117-2126. https://doi.org/10.1002/acr.25135

• Journal Article Type: Article
• Acceptance Date: Apr 1, 2023
• Online Publication Date: May 12, 2023
• Publication Date: 2023-10
• Deposit Date: Feb 27, 2024
• Publicly Available Date: Mar 1, 2024
• Journal: Arthritis Care & Research
• Print ISSN: 2151-464X
• Electronic ISSN: 2151-4658
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 75
• Issue: 10
• Pages: 2117-2126
• DOI: https://doi.org/10.1002/acr.25135
• Keywords: Rheumatology