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Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review
Open accessAbstract
PURPOSE: Exercise (planned, structured, repetitive movement) improves pain and function in people with persistent musculoskeletal pain (PMSK), but adherence is often poor. This systematic review evaluates the evidence from randomized controlled trials (RCTs) on the effectiveness of interventions to improve exercise adherence in people with PMSK and describes the content, context, and theoretical underpinning of behaviour change interventions designed to increase adherence. METHODS: Nine electronic databases were searched from inception dates to August 2017. Studies were included if they were RCTs that included adults with PMSK ≥3 months; ≥one measure of exercise adherence, exercise prescribed to both groups, and employed ≥one behaviour change technique (BCT) in the treatment group. Independent data extraction, theory coding, BCT taxonomy coding, and quality assessment using Cochrane Risk of Bias (RoB) tool was conducted by two reviewers. RESULTS: Eight RCTs (five low, three high RoB) met inclusion criteria. Five trials reported between-group differences in exercise adherence, favouring the treatment group. Three trials reported theoretical underpinning. There was moderate evidence that five BCTs, social support, goal setting, instruction of behaviour, demonstration of behaviour, and practice/rehearsal, improved exercise adherence. Interventions employing ≤seven BCTs, unique to those included in the control group, were most effective at enhancing exercise adherence. CONCLUSIONS: Limited moderate-quality evidence supports using a small number of BCTs to enhance exercise adherence in people with PMSK. Further research should explore the associations and synergies between BCTs and explicitly report how theory was utilized. This may inform recommendations for health care professionals working with this population. Statement of contribution What is already known on this subject? Exercise (i.e., planned, structured, repetitive movements) improves pain and function in people with persistent musculoskeletal pain (PMSK). Many people with PMSK do not adhere to exercises prescribed by a health care professional. Little research has explored how to enhance adherence to prescribed exercise in people with PMSK. What does this study add? Moderate-quality evidence from eight trials suggests behaviour change interventions enhance exercise adherence. Social support, goal setting, demonstration, instruction, and rehearsal were employed in effective interventions. Interventions with ≤7 behaviour change techniques were more effective at improving adherence than those employing >7.
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“Furthermore, the labor of psychologists may enhance adherence to exercise by conducting different behavioral change techniques or cognitive-behavioral programs [49,50,55,56,60,65].”
From Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review (2021) · cites this paper as [56]
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Health Behavior and Health Education: Theory, Research, and Practice
(1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-4-350_1 · Cited by 13,232
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995
Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., Altman, D. G., Barbour, V., Macdonald, H., Johnston, M., et al. (2014) · BMJ · doi:10.1136/bmj.g1687 · Cited by 10,548
(1985) · Europe PMC (PubMed Central) · Cited by 9,143
Osterberg, L., & Blaschke, T. (2005) · New England Journal of Medicine · doi:10.1056/nejmra050100 · Cited by 7,974
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9486-6 · Cited by 7,629
Adherence to Long-Term Therapies: Evidence for Action
Geest, S. D., & Sabate, E. J. (2003) · European Journal of Cardiovascular Nursing · doi:10.1016/s1474-5151(03)00091-4 · Cited by 6,310
Kirk, J. M. W., MacDonald, A., Lavender, P., Dean, J. M., & Rubin, G. (2017) · Biomedicine Hub · doi:10.1159/000480347 · Cited by 3,902
Prince, S. A., Adamo, K. B., Hamel, M., Hardt, J., Connor Gorber, S., & Tremblay, M. (2008) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-5-56 · Cited by 3,162
Webb, T. L., Joseph, J., Yardley, L., & Michie, S. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1376 · Cited by 2,517
Glanz, K., & Bishop, D. B. (2010) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.012809.103604 · Cited by 2,336
Effective techniques in healthy eating and physical activity interventions: A meta-regression.
Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S. (2009) · Health Psychology · doi:10.1037/a0016136 · Cited by 2,229
Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group
van Tulder, M., Furlan, A., Bombardier, C., & Bouter, L. (2003) · Spine · doi:10.1097/01.brs.0000065484.95996.af · Cited by 2,180
Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions
Noar, S. M., Benac, C. N., & Harris, M. S. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.4.673 · Cited by 2,136
Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., Britten, N., Roen, K., & Duffy, S. (2006) · Lancaster University · doi:10.13140/2.1.1018.4643 · Cited by 2,070
Planning Health Promotion Programs: An Intervention Mapping Approach
Hicking-Woodison, L. (2017) · Nursing Standard · doi:10.7748/ns.32.6.33.s38 · Cited by 1,843
Kelly, G. A. (1963) · W.W. Norton eBooks · Cited by 1,733
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2013) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2012.09.010 · Cited by 1,658
Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011279.pub3 · Cited by 1,222
The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials
Borrelli, B. (2011) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2011.00233.x · Cited by 970
Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review
Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E. (2010) · Manual Therapy · doi:10.1016/j.math.2009.12.004 · Cited by 929
Are interventions theory-based? Development of a theory coding scheme.
Michie, S., & Prestwich, A. (2010) · Health Psychology · doi:10.1037/a0016939 · Cited by 855
Toward a theory-based analysis of behavioral maintenance
Rothman, A. J. (2000) · Health Psychology · doi:10.1037/0278-6133.19.suppl1.64 · Cited by 783 · cited 1×
“However, the factors driving the initiation of a behaviour differ from those contributing to its maintenance (Rothman, 2000).”
BackgroundPhysical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011279.pub2 · Cited by 719
Does theory influence the effectiveness of health behavior interventions? Meta-analysis
Prestwich, A., Sniehotta, F. F., Whittington, C., Dombrowski, S. U., Rogers, L., & Michie, S. (2014) · Health Psychology · doi:10.1037/a0032853 · Cited by 562
Beyond Pleasure and PainHow Motivation Works
Higgins, E. T. (2011) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199765829.001.0001 · Cited by 549
UK BEAM Trial Team (2004) · BMJ · doi:10.1136/bmj.38282.669225.ae · Cited by 515
Reid, K. J., Harker, J., Bala, M. M., Truyers, C., Kellen, E., Bekkering, G. E., & Kleijnen, J. (2011) · Current Medical Research and Opinion · doi:10.1185/03007995.2010.545813 · Cited by 476
Behavioral Treatment for Chronic Low Back Pain
van Tulder, M. W., Ostelo, R., Vlaeyen, J. W. S., Linton, S. J., Morley, S., & Assendelft, W. J. (2001) · Spine · doi:10.1097/00007632-200102010-00012 · Cited by 456
Evidence-based behavioral medicine: What is it and how do we achieve it?
Davidson, K. W., Goldstein, M. G., Kaplan, R. M., Kaufmann, P. G., Knatterud, G. L., Orleans, C. T., Spring, B. J., Trudeau, K. J., & Whitlock, E. P. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2603_01 · Cited by 420
Gourlan, M., Bernard, P., Bortolon, C., Romain, A. J., Lareyre, O., Carayol, M., Ninot, G., & Boiché, J. (2016) · Health Psychology Review · doi:10.1080/17437199.2014.981777 · Cited by 353
Exercise therapy for fibromyalgia
Busch, A. J., Webber, S. C., Brachaniec, M., Bidonde, J., Bello-Haas, V. D., Danyliw, A. D., Overend, T. J., Richards, R. S., Sawant, A., & Schachter, C. L. (2011) · Current Pain and Headache Reports · doi:10.1007/s11916-011-0214-2 · Cited by 333
Friedrich, M., Gittler, G., Halberstadt, Y., Cermak, T., & Heiller, I. (1998) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/s0003-9993(98)90059-4 · Cited by 296
Beinart, N. A., Goodchild, C. E., Weinman, J. A., Ayis, S., & Godfrey, E. L. (2013) · The Spine Journal · doi:10.1016/j.spinee.2013.08.027 · Cited by 294
Beinart, N., Norton, S., Dowling, D., Gavriloff, D., Vari, C., Weinman, J. A., & Godfrey, E. L. (2016) · Physiotherapy · doi:10.1016/j.physio.2016.11.001 · Cited by 262
Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis
O'Connor, S. R., Tully, M. A., Ryan, B., Bleakley, C. M., Baxter, G. D., Bradley, J. M., & McDonough, S. M. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.12.003 · Cited by 234
Importance of enjoyment when promoting physical exercise
Hagberg, L. A., Lindahl, B., Nyberg, L., & Hellénius, M. ‐. (2009) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/j.1600-0838.2008.00844.x · Cited by 201
Theme issue on e-mental health: A growing field in internet research
Riper, H., Andersson, G., Christensen, H., Cuijpers, P., Lange, A., & Eysenbach, G. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1713 · Cited by 200
UK BEAM Trial Team (2004) · BMJ · doi:10.1136/bmj.38282.607859.ae · Cited by 197
Peek, K., Sanson-Fisher, R., Mackenzie, L., & Carey, M. (2016) · Physiotherapy · doi:10.1016/j.physio.2015.10.003 · Cited by 183
Härkäpää, K., Jarvikoski, A., Mellin, G., Hurri, H., & Luoma, J. (1991) · Pain · doi:10.1016/0304-3959(91)90031-r · Cited by 172
Vong, S. K. S., Cheing, G. L. Y., Chan, F., So, E. M. L., & Chan, C. C. H. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.10.016 · Cited by 167
Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults.
Jordan, J. L., Holden, M., Mason, E. E., & Foster, N. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005956.pub2 · Cited by 166
Friedrich, M., Gittler, G., Arendasy, M. E., & Friedrich, K. (2005) · Spine · doi:10.1097/01.brs.0000160844.71551.af · Cited by 147
Sensory environment on health-related outcomes of hospital patients
Drahota, A., Ward, D., MacKenzie, H., Stores, R., Higgins, B., Gal, D., & Dean, T. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005315.pub2 · Cited by 123
Bishop, F. L., Fenge-Davies, A. L., Kirby, S., & Geraghty, A. W. A. (2015) · Psychology & Health · doi:10.1080/08870446.2014.953529 · Cited by 121
Keogh, A., Tully, M. A., Matthews, J. J., & Hurley, D. A. (2015) · Manual Therapy · doi:10.1016/j.math.2015.03.014 · Cited by 106
Härkäpää, K., Mellin, G. P., Järvikoski, A., & Hurri, H. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/165019779022181188 · Cited by 93
O'Keeffe, M., Hayes, A., McCreesh, K., Purtill, H., & O'Sullivan, K. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-095410 · Cited by 77
Coppack, R. J., Kristensen, J., & Karageorghis, C. I. (2012) · Clinical Rehabilitation · doi:10.1177/0269215512436613 · Cited by 68
Arvinen‐Barrow, M., Penny, G. N., Hemmings, B., & Corr, S. (2009) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2009.05.004 · Cited by 66
Reilly, K., Lovejoy, B., Williams, R. D., & Roth, H. (1989) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-198906000-00012 · Cited by 63
Hall, A. M., Kamper, S. J., Hernon, M., Hughes, K., Kelly, G. A., Lonsdale, C., Hurley, D. A., & Ostelo, R. (2014) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.07.405 · Cited by 63
Bearne, L., Byrne, A.-M., Segrave, H., & White, C. M. (2015) · Rheumatology International · doi:10.1007/s00296-015-3380-4 · Cited by 56
Larkin, L., Gallagher, S. M., Cramp, F. L., Brand, C. J., Fraser, A. D., & Kennedy, N. (2015) · Rheumatology International · doi:10.1007/s00296-015-3292-3 · Cited by 52
Exercise for workers with musculoskeletal pain: Does enhancing compliance decrease pain?
Linton, S. J., Hellsing, A.-L., & Bergström, G. (1996) · Journal of Occupational Rehabilitation · doi:10.1007/bf02110754 · Cited by 42
Walsh, D. A. (2017) · Lara D. Veeken · doi:10.1093/rheumatology/kex060.083 · Cited by 40
Feasibility of an Exercise‐Based Rehabilitation Programme for Chronic Hip Pain
Bearne, L., Walsh, N. E., Jessep, S., & Hurley, M. (2011) · Musculoskeletal Care · doi:10.1002/msc.209 · Cited by 38
Ami, N. B., Chodick, G., Mirovsky, Y., Pincus, T., & Shapiro, Y. (2017) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2017.7057 · Cited by 38
Galea, M. N., Weinman, J., White, C. M., & Bearne, L. (2013) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2013.03.030 · Cited by 37
Peterson, G., Ludvigsson, M. L., O’Leary, S. P., Dedering, Å., Wallman, T., Jönsson, M., & Peolsson, A. L. C. (2015) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2015.06.011 · Cited by 36
Adherence to sport injury rehabilitation: implications for sports medicine providers and researchers
Spetch, L. A., & Kolt, G. S. (2001) · Physical Therapy in Sport · doi:10.1054/ptsp.2001.0062 · Cited by 33
Factor affecting adherence to rehabilitation interventions for individuals with fibromyalgia.
Huyser, B. A., Buckelew, S. P., Hewett, J. E., & Johnson, J. C. (1997) · Rehabilitation Psychology · doi:10.1037/0090-5550.42.2.75 · Cited by 24
Greenhalgh, S., & Selfe, J. (2006) · Elsevier eBooks · doi:10.1016/b978-0-443-10140-3.50005-3 · Cited by 17
Härkäpää, K., Järvikoski, A., Mellin, G. P., et al. (1990) · Pain · doi:10.1016/0304-3959(90)92888-w · Cited by 7
Flagged first, then by citations
Research works printed but not linked: 5
- Bandura A., 1986, Social foundations of thought and action: A social cognitive theory
- Clinical Standards Advisory Group, 2000, Services for patients with pain
- Dieppe P., 2012, ABF of pain, 16
- Harkapaa K., 1990, A controlled study on the outcome of inpatient and outpatient treatment of low back pain, Scandinavian Journal of Rehabilitation Medicine, 22, 181, 10.2340/165020051990181188 · DOI
- Lefcourt H. M., 1981, Research with the locus of control construct vol. 1, assessment methods
Cited by
Sorted by citations
Collado-Mateo, D., Lavín-Pérez, A. M., Peñacoba, C., Del Coso, J., Leyton-Román, M., Luque-Casado, A., Gasque, P., Fernández-del-Olmo, M. Á., & Amado-Alonso, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18042023 · Cited by 791
Wolf, S., Seiffer, B., Zeibig, J., Welkerling, J., Brokmeier, L. L., Atrott, B., Ehring, T. W., & Schuch, F. B. (2021) · Sports Medicine · doi:10.1007/s40279-021-01468-z · Cited by 327
Lambert, J. E., Hayes, L. D., Keegan, T., Subar, D. A., & Gaffney, C. J. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000004527 · Cited by 201
Whittaker, J. L., Culvenor, A. G., Juhl, C. B., Berg, B., Bricca, A., Filbay, S. R., Holm, P. M., Macri, E. M., Urhausen, A. P., Ardern, C. L., et al. (2022) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-106299 · Cited by 139
Black, N., Johnston, M., Michie, S., Hartmann‐Boyce, J., West, R., Viechtbauer, W., Eisma, M. C., Scott, C., & de Bruin, M. (2020) · Addiction · doi:10.1111/add.15056 · Cited by 111
Metadata
- Authors
- Meade, L. B., Bearne, L. M., Sweeney, L. H., Alageel, S. H., & Godfrey, E. L.
- Affiliations
- King's College London (GB)
- Corresponding author
- Meade, Laura B.
- Godfrey, Emma L.
- Venue
- British Journal of Health Psychology
- Publisher
- Wiley
- Published
- 2018-06-17
- Volume
- 24
- Issue
- 1
- Pages
- 10-30
- ISSN
- 1359-107X (ISSN-L)
- 2044-8287
- PMC
- PMC6585717
- OpenAlex
- W2803407939
- Cited by
- 152
- References
- 67
- Citations by year
- 2026: 20 · 2025: 23 · 2024: 22 · 2023: 16 · 2022: 29 · 2021: 22 · 2020: 16 · 2019: 3
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Health Psychology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Repository (Kingston University London) (acceptedVersion)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- behaviour change techniques, exercise adherence, chronic musculoskeletal pain, behaviour change interventions, social support, goal setting, BCT taxonomy
- MeSH terms
- Adolescent, Adult, Aged, Behavior Therapy, Exercise Therapy, Female, Humans, Male, Middle Aged, Patient Compliance, Randomized Controlled Trials as Topic, Young Adult, Musculoskeletal Pain
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