Evidence summary of improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis_West China Medical Journal

Authors：

HOU Ailin ,  NING Ning , CHEN Jiali , LI Peifang , ZHOU Zongke , LIAO Xia , MA Yanfei

West China School of Nursing, Sichuan University / Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NING Ning, Email: gkningning@126.com

Keywords：

Osteoarthritis, knee; non-surgical; exercise therapy; adherence; evidence summary

DOI：

10.7507/1002-0179.202207075

Video：

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Objective To summarize the best evidence for improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis (KOA), so as to provide an evidence-based basis and reference for healthcare professionals, managers, patients, and caregivers. Methods Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses Association of Ontario, National Guideline Clearinghouse, American College of Rheumatology, Osteoarthritis Research Society International, Turkish League Against Rheumatism, European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, System for Information on Grey Literature in Europe, Cochrane Library, PubMed, Joanna Briggs Library, www.guide.medlive.cn, China National Knowledge Infrastructure, and WanFang Data were searched by computer for literature about improving exercise therapy compliance in non-surgical patients with KOA. The retrieval time limit was from January 1, 2017 to April 20, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training, and ultimately evidence was extracted from the literature that met the quality evaluation criteria. Results A total of 12 publications were included, including 5 guidelines, 4 systematic reviews, and 3 expert consensuses, covering 6 aspects of multidisciplinary teamwork, development of individualized exercise plans, external support, interventions, health education, and follow-up management. A total of 18 best evidences for improving exercise therapy compliance in non-surgical patients with KOA were summarized, with 8 A-level recommendations and 10 B-level recommendations. Conclusions When applying the evidence, clinical staff should fully assess and develop exercise plans with individual patients, strengthen multidisciplinary communication and writing, make full use of external support resources and do health education and full follow-up management. Through comprehensive consideration and selection of the best evidence for implementation, the compliance of KOA non-surgical patients with exercise therapy can be improved.

Citation： HOU Ailin, NING Ning, CHEN Jiali, LI Peifang, ZHOU Zongke, LIAO Xia, MA Yanfei. Evidence summary of improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis. West China Medical Journal, 2022, 37(10): 1524-1530. doi: 10.7507/1002-0179.202207075 Copy

1.	中华医学会骨科学分会关节外科学组, 中国医师协会骨科医师分会骨关节炎学组, 国家老年疾病临床医学研究中心(湘雅医院), 等. 中国骨关节炎诊疗指南(2021 年版). 中华骨科杂志, 2021, 41(18): 1291-1314.
2.	Liu Q, Niu J, Li H, et al. Knee symptomatic osteoarthritis, walking disability, NSAIDs use and all-cause mortality: population-based Wuchuan osteoarthritis study. Sci Rep, 2017, 7(1): 3309.
3.	Raposo F, Ramos M, Lúcia Cruz A. Effects of exercise on knee osteoarthritis: a systematic review. Musculoskeletal Care, 2021, 19(4): 399-435.
4.	World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization Library, 2003[2022-07-01]. https://apps.who.int/iris/handle/10665/42682.
5.	Nicolson PJA, Hinman RS, Kasza J, et al. Trajectories of adherence to home-based exercise programs among people with knee osteoarthritis. Osteoarthritis Cartilage, 2018, 26(4): 513-521.
6.	Pisters MF, Veenhof C, Schellevis FG, et al. Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee. Arthritis Care Res (Hoboken), 2010, 62(8): 1087-1094.
7.	周芬, 郝玉芳, 丛雪, 等. 指南研究与评价工具 AGREE Ⅱ及各领域分值的补充解释及思考. 护理学报, 2018, 25(18): 56-58.
8.	顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具—系统评价的方法学质量评价. 护士进修杂志, 2018, 33(8): 701-703.
9.	胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018: 56-67.
10.	Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken), 2020, 72(2): 149-162.
11.	Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019, 27(11): 1578-1589.
12.	Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two:strengthening exercise programs. Clin Rehabil, 2017, 31(5): 596-611.
13.	膝骨关节炎运动治疗临床实践指南编写组. 膝骨关节炎运动治疗临床实践指南. 中华医学杂志, 2020, 100(15): 1123-1129.
14.	van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, et al. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care, 2020, 18(4): 575-595.
15.	O’Keeffe M, Hayes A, McCreesh K, et al. Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis. Br J Sports Med, 2017, 51(2): 126-132.
16.	Nicolson PJA, Bennell KL, Dobson FL, et al. Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis. Br J Sports Med, 2017, 51(10): 791-799.
17.	Willett M, Duda J, Fenton S, et al. Effectiveness of behaviour change techniques in physiotherapy interventions to promote physical activity adherence in lower limb osteoarthritis patients: a systematic review. PloS one, 2019, 14(7): e0219482.
18.	Cinthuja P, Krishnamoorthy N, Shivapatham G. Effective interventions to improve long-term physiotherapy exercise adherence among patients with lower limb osteoarthritis. A systematic review. BMC Musculoskelet Disord, 2022, 23(1): 147.
19.	Tuncer T, Cay FH, Altan L, et al. 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis. Rheumatol Int, 2018, 38(8): 1315-1331.
20.	Rausch Osthoff AK, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis, 2018, 77(9): 1251-1260.
21.	Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). Semin Arthritis Rheum, 2019, 49(3): 337-350.
22.	王荃, 杜英华, 高进辽. 多学科合作护理模式在稳定期 COPD 患者中的应用效果研究. 护理管理杂志, 2021, 21(12): 897-901.
23.	Marks R. Knee osteoarthritis and exercise adherence: a review. Curr Aging Sci, 2012, 5(1): 72-83.
24.	Campbell R, Evans M, Tucker M, et al. Why don’t patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health, 2001, 55(2): 132-138.
25.	Jack K, McLean SM, Moffett JK, et al. Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Man Ther, 2010, 15(3): 220-228.
26.	Quicke JG, Runhaar J, van der Windt DA, et al. Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: a systematic review of sub-group analyses from randomised controlled trials. Osteoarthr Cartil Open, 2020, 2(4): 100113.
27.	Jordan JL, Holden MA, Mason EE, et al. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev, 2010(1): CD005956.
28.	International Consortium for Health Outcomes Measurement. Hip & knee osteoarthritis data collection reference guide. (2017-04-10)[2022-07-01]. https://ichom.org/files/medical-conditions/hip-knee-osteoarthritis/hip-knee-osteoarthritis-reference-guide.pdf.
29.	Holden MA, Button K, Collins NJ, et al. Guidance for implementing best practice therapeutic exercise for patients with knee and hip osteoarthritis: what does the current evidence base tell us?. Arthritis Care Res (Hoboken), 2021, 73(12): 1746-1753.
30.	Nicolson PJA, Hinman RS, French SD, et al. Improving adherence to exercise: do people with knee osteoarthritis and physical therapists agree on the behavioral approaches likely to succeed?. Arthritis Care Res (Hoboken), 2018, 70(3): 388-397.
31.	Ledingham A, Cohn ES, Baker KR, et al. Exercise adherence: beliefs of adults with knee osteoarthritis over 2 years. Physiother Theory Pract, 2020, 36(12): 1363-1378.
32.	Meade LB, Bearne LM, Sweeney LH, et al. Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: systematic review. Br J Health Psychol, 2019, 24(1): 10-30.
33.	Li LC, Sayre EC, Xie H, et al. A community-based physical activity counselling program for people with knee osteoarthritis: feasibility and preliminary efficacy of the track-OA study. JMIR Mhealth Uhealth, 2017, 5(6): e86.
34.	Henriksen M, Christensen R, Klokker L, et al. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee: a randomized clinical trial. JAMA Intern Med, 2015, 175(6): 923-930.
35.	Bennell K, Nelligan RK, Schwartz S, et al. Behavior change text messages for home exercise adherence in knee osteoarthritis: randomized trial. J Med Internet Res, 2020, 22(9): e21749.
36.	Bunzli S, O’Brien P, Ayton D, et al. Misconceptions and the acceptance of evidence-based nonsurgical interventions for knee osteoarthritis. A qualitative study. Clin Orthop Relat Res, 2019, 477(9): 1975-1983.
37.	Lambert TE, Harvey LA, Avdalis C, et al. An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: a randomised trial. J Physiother, 2017, 63(3): 161-167.
38.	Bennell KL, Campbell PK, Egerton T, et al. Telephone coaching to enhance a home-based physical activity program for knee osteoarthritis: a randomized clinical trial. Arthritis Care Res (Hoboken), 2017, 69(1): 84-94.

1. 中华医学会骨科学分会关节外科学组, 中国医师协会骨科医师分会骨关节炎学组, 国家老年疾病临床医学研究中心(湘雅医院), 等. 中国骨关节炎诊疗指南(2021 年版). 中华骨科杂志, 2021, 41(18): 1291-1314.
2. Liu Q, Niu J, Li H, et al. Knee symptomatic osteoarthritis, walking disability, NSAIDs use and all-cause mortality: population-based Wuchuan osteoarthritis study. Sci Rep, 2017, 7(1): 3309.
3. Raposo F, Ramos M, Lúcia Cruz A. Effects of exercise on knee osteoarthritis: a systematic review. Musculoskeletal Care, 2021, 19(4): 399-435.
4. World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization Library, 2003[2022-07-01]. https://apps.who.int/iris/handle/10665/42682.
5. Nicolson PJA, Hinman RS, Kasza J, et al. Trajectories of adherence to home-based exercise programs among people with knee osteoarthritis. Osteoarthritis Cartilage, 2018, 26(4): 513-521.
6. Pisters MF, Veenhof C, Schellevis FG, et al. Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee. Arthritis Care Res (Hoboken), 2010, 62(8): 1087-1094.
7. 周芬, 郝玉芳, 丛雪, 等. 指南研究与评价工具 AGREE Ⅱ及各领域分值的补充解释及思考. 护理学报, 2018, 25(18): 56-58.
8. 顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具—系统评价的方法学质量评价. 护士进修杂志, 2018, 33(8): 701-703.
9. 胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018: 56-67.
10. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken), 2020, 72(2): 149-162.
11. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019, 27(11): 1578-1589.
12. Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two:strengthening exercise programs. Clin Rehabil, 2017, 31(5): 596-611.
13. 膝骨关节炎运动治疗临床实践指南编写组. 膝骨关节炎运动治疗临床实践指南. 中华医学杂志, 2020, 100(15): 1123-1129.
14. van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, et al. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care, 2020, 18(4): 575-595.
15. O’Keeffe M, Hayes A, McCreesh K, et al. Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis. Br J Sports Med, 2017, 51(2): 126-132.
16. Nicolson PJA, Bennell KL, Dobson FL, et al. Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis. Br J Sports Med, 2017, 51(10): 791-799.
17. Willett M, Duda J, Fenton S, et al. Effectiveness of behaviour change techniques in physiotherapy interventions to promote physical activity adherence in lower limb osteoarthritis patients: a systematic review. PloS one, 2019, 14(7): e0219482.
18. Cinthuja P, Krishnamoorthy N, Shivapatham G. Effective interventions to improve long-term physiotherapy exercise adherence among patients with lower limb osteoarthritis. A systematic review. BMC Musculoskelet Disord, 2022, 23(1): 147.
19. Tuncer T, Cay FH, Altan L, et al. 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis. Rheumatol Int, 2018, 38(8): 1315-1331.
20. Rausch Osthoff AK, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis, 2018, 77(9): 1251-1260.
21. Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). Semin Arthritis Rheum, 2019, 49(3): 337-350.
22. 王荃, 杜英华, 高进辽. 多学科合作护理模式在稳定期 COPD 患者中的应用效果研究. 护理管理杂志, 2021, 21(12): 897-901.
23. Marks R. Knee osteoarthritis and exercise adherence: a review. Curr Aging Sci, 2012, 5(1): 72-83.
24. Campbell R, Evans M, Tucker M, et al. Why don’t patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health, 2001, 55(2): 132-138.
25. Jack K, McLean SM, Moffett JK, et al. Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Man Ther, 2010, 15(3): 220-228.
26. Quicke JG, Runhaar J, van der Windt DA, et al. Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: a systematic review of sub-group analyses from randomised controlled trials. Osteoarthr Cartil Open, 2020, 2(4): 100113.
27. Jordan JL, Holden MA, Mason EE, et al. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev, 2010(1): CD005956.
28. International Consortium for Health Outcomes Measurement. Hip & knee osteoarthritis data collection reference guide. (2017-04-10)[2022-07-01]. https://ichom.org/files/medical-conditions/hip-knee-osteoarthritis/hip-knee-osteoarthritis-reference-guide.pdf.
29. Holden MA, Button K, Collins NJ, et al. Guidance for implementing best practice therapeutic exercise for patients with knee and hip osteoarthritis: what does the current evidence base tell us?. Arthritis Care Res (Hoboken), 2021, 73(12): 1746-1753.
30. Nicolson PJA, Hinman RS, French SD, et al. Improving adherence to exercise: do people with knee osteoarthritis and physical therapists agree on the behavioral approaches likely to succeed?. Arthritis Care Res (Hoboken), 2018, 70(3): 388-397.
31. Ledingham A, Cohn ES, Baker KR, et al. Exercise adherence: beliefs of adults with knee osteoarthritis over 2 years. Physiother Theory Pract, 2020, 36(12): 1363-1378.
32. Meade LB, Bearne LM, Sweeney LH, et al. Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: systematic review. Br J Health Psychol, 2019, 24(1): 10-30.
33. Li LC, Sayre EC, Xie H, et al. A community-based physical activity counselling program for people with knee osteoarthritis: feasibility and preliminary efficacy of the track-OA study. JMIR Mhealth Uhealth, 2017, 5(6): e86.
34. Henriksen M, Christensen R, Klokker L, et al. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee: a randomized clinical trial. JAMA Intern Med, 2015, 175(6): 923-930.
35. Bennell K, Nelligan RK, Schwartz S, et al. Behavior change text messages for home exercise adherence in knee osteoarthritis: randomized trial. J Med Internet Res, 2020, 22(9): e21749.
36. Bunzli S, O’Brien P, Ayton D, et al. Misconceptions and the acceptance of evidence-based nonsurgical interventions for knee osteoarthritis. A qualitative study. Clin Orthop Relat Res, 2019, 477(9): 1975-1983.
37. Lambert TE, Harvey LA, Avdalis C, et al. An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: a randomised trial. J Physiother, 2017, 63(3): 161-167.
38. Bennell KL, Campbell PK, Egerton T, et al. Telephone coaching to enhance a home-based physical activity program for knee osteoarthritis: a randomized clinical trial. Arthritis Care Res (Hoboken), 2017, 69(1): 84-94.

West China Medical Journal

Evidence summary of improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis

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