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Perceived barriers and facilitators to exercise adherence in osteoarthritis: Athematic synthesis of qualitative studies.

Giardulli, Benedetto; Marazzi, Davide; Nespoli, Alessandro; Leuzzi, Gaia; Dell'Isola, Andrea; Prior, Yeliz; Battista, Simone

Perceived barriers and facilitators to exercise adherence in osteoarthritis: Athematic synthesis of qualitative studies. Thumbnail


Authors

Benedetto Giardulli

Davide Marazzi

Alessandro Nespoli

Gaia Leuzzi

Andrea Dell'Isola



Abstract

ObjectiveExercise is a first-line intervention for osteoarthritis (OA). However, exercise adherence remains low, and existing studies exploring factors influencing adherence have yielded inconclusive results based on quantitative data. This study aims to synthesise qualitative studies focused on the perceived facilitators and barriers affecting exercise adherence in individuals with OA.DesignA thematic synthesis of qualitative studies was conducted. Relevant articles were sourced from MEDLINE, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and PsychInfo until November 2024. Studies focused on adults (≥16 years) with hip or knee OA who had participated in exercise programmes to manage OA. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Data analysis followed Thematic Synthesis by Thomas & Harden to identify descriptive and analytical themes. The confidence of the evidence was evaluated through the Confidence in Evidence from Reviews of Qualitative Research (CERQual).ResultsA total of 21 studies involving 458 participants were included. From seven descriptive themes, three analytical themes were developed: (i) Mind-Body Connection, (ii) Social Support Systems, and (iii) Environmental Enablers. These themes underscore the importance of personal beliefs, experiences, and mindsets, alongside social and environmental factors, in promoting or hindering exercise adherence.ConclusionThis study highlights the multifaceted cognitive, social, and environmental factors influencing exercise adherence in individuals with OA. The findings suggest that a 'one-size-fits-all' approach is insufficient for promoting sustained exercise engagement. Future quantitative research should build upon these insights to develop tailored strategies for enhancing exercise adherence in people with OA.

Journal Article Type Article
Acceptance Date Feb 11, 2025
Online Publication Date Feb 15, 2025
Publication Date Jun 1, 2025
Deposit Date Feb 24, 2025
Publicly Available Date Feb 26, 2025
Journal Osteoarthritis and cartilage open
Electronic ISSN 2665-9131
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 7
Issue 2
Article Number 100584
Pages 100584
DOI https://doi.org/10.1016/j.ocarto.2025.100584
Keywords Qualitative Research, Physical Therapy Modalities, Physical Therapy Specialty, Treatment Adherence And Compliance
PMID 40061841

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