A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties
Open accessAbstract
Background: Adherence is an important factor contributing to the effectiveness of exercise-based rehabilitation. However, there appears to be a lack of reliable, validated measures to assess self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. Objectives: A systematic review was conducted to establish what measures were available and to evaluate their psychometric properties. Data sources: MEDLINE, EMBASE, PsycINFO CINAHL (June 2013) and the Cochrane library were searched (September 2013). Reference lists from articles meeting the inclusion criteria were checked to ensure all relevant papers were included. Study selection: To be included articles had to be available in English; use a self-report measure of adherence in relation to a prescribed but unsupervised home-based exercise or physical rehabilitation programme; involve participants over the age of 18. All health conditions and clinical populations were included. Data extraction: Descriptive data reported were collated on a data extraction sheet. The measures were evaluated in terms of eight psychometric quality criteria. Results: 58 studies were included, reporting 61 different measures including 29 questionnaires, 29 logs, two visual analogue scales and one tally counter. Only two measures scored positively for one psychometric property (content validity). The majority of measures had no reported validity or reliability testing. Conclusions: The results expose a gap in the literature for well-developed measures that capture self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises.
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Self-reported exercise adherence assessment can be invalid, and no valid and reliable measurement method exists for unsupervised exercise adherence.
“According to the previous systematic review, self-reported exercise adherence assessment can be invalid; however, there exists no valid and reliable measurement method for unsupervised exercise adherence [50].”
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- Authors
- Bollen, J. C., Dean, S. G., Siegert, R. J., Howe, T. E., & Goodwin, V. A.
- Affiliations
- University of Exeter (GB)
- Auckland University of Technology (NZ)
- Glasgow Caledonian University (GB)
- Corresponding author
- Bollen, Jessica C
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2014-06
- Volume
- 4
- Issue
- 6
- Pages
- e005044
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4078771
- OpenAlex
- W2133331846
- Cited by
- 217
- References
- 80
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 23 · 2023: 24 · 2022: 14 · 2021: 18 · 2020: 28 · 2019: 19 · 2018: 24 · 2017: 19 · 2016: 15 · 2015: 4 · 2014: 2
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion, other-oa)
- Figshare (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by-nc)
- ResearchOnline (submittedVersion, cc-by-nc)
- Funders
- National Institute for Health and Care Research (RDA/02/06/41)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- exercise adherence, home-based rehabilitation, self-reported adherence, psychometric properties, unsupervised exercise, physical rehabilitation, reliability and validity, content validity
- MeSH terms
- Exercise Therapy, Home Care Services, Humans, Patient Compliance, Psychometrics, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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