Adherence to Home-Based Exercises in Musculoskeletal Disorders

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

252 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-07-18

Study Completion Date

2026-02-28

Brief Summary

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Home exercise program is recommended by physicians to patients and their relatives to do at home and It is a treatment option in which the physician describes how to do it. Home workout program to be completed at home to complement and reinforce their program in the clinic It is a personalized set of therapeutic exercises that are taught. There are factors that can change exercise compliance; There are some reasons why some patients adhere to the prescribed home exercise program and others do not.

Adherence to home exercises is a major issue in rehabilitation and the reasons for this are multifactorial; It includes both psychological and specific conditions factors that vary between each individual and these conditions should be taken into account by clinicians in designing personalized exercise programs.

Home exercise programs constitute a fundamental component of rehabilitation and are widely prescribed by physicians support therapeutic gains beyond the clinical environment. These individualized programs aim to maintain functional improvements, reduce symptoms, and promote self-management among individuals with musculoskeletal disorders. Although adherence to home-based exercises is recognized as a key determinant of rehabilitation outcomes, non-adherence remains a persistent challenge. Despite growing emphasis on the importance of exercise compliance, the existing literature provides relatively limited and insufficient evidence regarding the factors that influence adherence across different musculoskeletal conditions, including degenerative, orthopedic, and neurological disorders.

Addressing this gap, the present prospective longitudinal cohort study aims to evaluate adherence to individualized home-based exercise programs among patients with diverse musculoskeletal conditions and to determine whether adherence behaviors differ across diagnostic groups. In addition, the study seeks to identify demographic, clinical, psychosocial, and functional factors associated with exercise compliance. By integrating structured clinical evaluations with validated outcome measures, this study aims not only to clarify the determinants of exercise adherence but also to contribute to the development of more effective, condition-specific strategies to enhance sustained engagement in home-based rehabilitation.

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Detailed Description

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Home exercise programs are recommended by physicians to patients and when appropriate, their caregivers as interventions to be performed outside the clinical setting. In this treatment approach, the physician provides detailed instructions on how the exercises should be carried out. These programs consist of individualized therapeutic exercises designed to be performed at home, with the aim of complementing and reinforcing the interventions delivered in the clinic. Addressing this gap, the present study aims to evaluate adherence to individualized home-based exercise programs among patients with diverse musculoskeletal conditions and to determine whether adherence behaviors differ across diagnostic groups. In addition, the study seeks to identify demographic, clinical, psychosocial, and functional factors associated with exercise compliance. By integrating structured clinical evaluations with validated outcome measures, this study aims not only to clarify the determinants of exercise adherence but also to contribute to the development of more effective, condition-specific strategies to enhance sustained engagement in home-based rehabilitation.

Meeting the inclusion and exclusion criteria; various musculoskeletal diseases; Patients presenting for degenerative, orthopedic or neurological rehabilitation will be included in the study by obtaining written informed consent after an individualized home exercise program after a detailed clinical examination.

Questions such as age, gender, height, weight, education level, employment status, income level and sociodemographic and clinical characteristics of the participants (diagnosis of the disease, duration, comorbidity/cumulative disease score status, medical treatment status, if any, pain/weakness level, functional status) will be recorded.

All patients will receive an individualized home exercise program based on their clinical condition. Exercises will be determined by the physical therapy and rehabilitation physician, taking into account the minimum clinical needs and individual characteristics of the patient. People receiving active physical therapy; will not be included in the study. In terms of content, general physical therapy will consist of exercises, not specific exercises that are rarely practiced or performed by a health professional. The number of sets of exercises per day, how many times they will be done in each set and how many days a week will be defined and recorded. The exercises will be explained to the patient by the physician and the printed paper describing these exercises will be given to the patient.

Three condition-specific subcohorts will be defined: chronic degenerative, orthopedic (post-operative) and neurological patients. Patients in the degenerative, orthopedic, or neurological rehabilitation groups will be provided with a patient-specific home exercise program, and their adherence and adaptations to the program will be evaluated and compared. Patients will do the home-based exercise program for 6 weeks. Patients will undergo both clinical and outcome-based assessments at baseline and again at the completion of the home exercise program (6 weeks).

Among the result criteria; Primary variables; Beck Depression Index (BDI) for mood, Health Assessment Questionnaire (HAQ) for quality of life, Kinesiophobia assessment; Tampa Kinesiophobia Scale, Visual Analog Scale (VAS 0-10), for Activities of Daily Living; Barthel Activities of Daily Living Index Secondary variables; to assess how an individual's health condition affects their daily life for exercise adherence; The Exercise Adherence Rating Scale/Exercise Attitude Questionnarie. All assessments will be evaluated by a group-blind investigator after 6 weeks with clinical examination and a set of evaluation scales/questionnaires. The patients' clinical status, satisfactions, their adherence to exercise therapy, and the factors influencing this adherence will be evaluated. Patients whose diagnosis was established after a detailed examination and for whom an exercise program was prescribed will be included in the study. The decision will be based solely on the patient's ability to perform the exercises and adherence to the inclusion and exclusion criteria. Other factors that could potentially introduce bias, such as education level or the patient's willingness to exercise, will not be considered in determining treatment, in order to minimize selection bias. Patients will be instructed not to take any analgesics within 24 hours prior to the assessment.

Conditions

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Exercise Training Adherence, Treatment Musculoskeletal Disease Rehabilitation Exercise Adherence, Patient Home Exercise Program

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Degenerative

Patients with chronic degenerative musculoskeletal disorders receiving a home exercise program (subcohort)

Home exercise program

Intervention Type OTHER

Patients with chronic degenerative musculoskeletal disorders receiving a home exercise program

Orthopedic

Patients receiving a home exercise program as part of post-operative orthopedic rehabilitation (subcohort)

Home exercise program

Intervention Type OTHER

Patients receiving a home exercise program following a neurological condition as part of rehabilitation

Neurological

Patients receiving a home exercise program following a neurological condition as part of rehabilitation (subcohort)

Home exercise program

Intervention Type OTHER

Patients receiving a home exercise program as part of post-operative orthopedic rehabilitation

Interventions

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Home exercise program

Patients with chronic degenerative musculoskeletal disorders receiving a home exercise program

Intervention Type OTHER

Home exercise program

Patients receiving a home exercise program as part of post-operative orthopedic rehabilitation

Intervention Type OTHER

Home exercise program

Patients receiving a home exercise program following a neurological condition as part of rehabilitation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Be 18 years of age or older
* To have a musculoskeletal disease (degenerative, neurological or orthopedic)
* To be given a home exercise program
* To have cognitive and language functions to communicate, to be a volunteer

Exclusion Criteria

* Those with major psychiatric illness
* Those with cognitive dysfunction
* Those with communication disorders, reluctant/reluctant to participate
* Those with any condition other than a primary degenerative, orthopedic, or neurological disease that could significantly affect exercise adherence, including musculoskeletal or systemic disorders (e.g., severe anemia, heart failure, respiratory failure, uncontrolled diabetes, inflammatory rheumatic disease, recent fractures, or active infections).

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No