What Adherence Measures Should Be Used in Trials of Home-Based Rehabilitation Interventions? A Systematic Review of the Validity, Reliability, and Acceptability of Measures (2024)

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A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties

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Tracey Howe, Sarah Dean

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. A systematic review was conducted to establish what measures were available and to evaluate their psychometric properties. 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. 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. Descriptive data reported were collated on a data extraction sheet. The measures ...

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Annals of Physical and Rehabilitation Medicine

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Anis Jellad, Soumaya Boudokhane

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Rebecca Speckman

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Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions: overview and methodology

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Jeff Susman

A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of low back, neck, knee, and shoulder pain. Evidence from randomized controlled trials (RCTs) and observational studies was identified and synthesized using methods defined by the Cochrane Collaboration that minimize bias by using a systematic approach to literature search, study selection, data extraction, and data synthesis. Meta-analyses were conducted where possible. The strength of evidence was graded as level I for RCTs or level II for nonrandomized studies. An expert panel was formed by inviting stakeholder professional organizations to nominate a representative. This panel developed a set of criteria for grading the strength of both the evidence and the recommendation. The panel decided that evidence of clinically important benefit (defined as 15% greater r...

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The Spine Journal

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Salma Ayis

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Patientâs adherence to prescribed home exercises: Barriers and interventions

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Khodor Haidar Hassan

Purpose: The purpose of this study is to evaluate patients’ adherence to home exercise programs in physical therapy practice in Lebanon, to learn which factors determine the level of adherence, and the methods used to promote it. Materials and methods: An online questionnaire was sent to a random group of Lebanese physical therapists. 44 respondents were included. 22 (50%) have 4-10 years of experience while the other 22 (50%) have more than 10 years of experience. The answers were submitted anonymously using an online application (Survey Monkey). Data were collected, and simple statistical analysis and calculation of percentages were performed. Results: Only 36% of respondents reported high level of adherence to home exercises among their patients. The following factors were reported to have a significant effect on adherence: age, self-efficacy, fatigue, understanding and memorizing exercises, and time. The results were in line with the data published in the literature. Among the m...

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Musculoskeletal Care

A model to increase rehabilitation adherence to home exercise programmes in patients with varying levels of self-efficacy

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Kelsey Picha

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Analysis of home-based rehabilitation in patients with motor impairment in primary care: a prospective observational study

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Practice-Based Evidence Research in Rehabilitation: An Alternative to Randomized Controlled Trials and Traditional Observational Studies

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Daniel Deutscher

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Small Sample Research Designs for Evidence-Based Rehabilitation: Issues and Methods

Kenneth Ottenbacher

Graham JE, Karmarkar AM, Ottenbacher KJ. Small sample research designs for evidence-based rehabilitation: issues and methods. Arch Phys Med Rehabil 2012;93 (8 Suppl 2):S111-6. Conventional research methods, including randomized controlled trials, are powerful techniques for determining the efficacy of interventions. These designs, however, have practical limitations when applied to many rehabilitation settings and research questions. Alternative methods are available that can supplement findings from traditional research designs and improve our ability to evaluate the effectiveness of treatments for individual patients. The focus on individual patients is an important element of evidenced-based rehabilitation. This article examines one such alternate approach: small-N research designs. Small-N designs usually focus on 10 or fewer participants whose behavior (outcomes) are measured repeatedly and compared over time. The advantages and limitations of various small-N designs are described and illustrated using 3 examples from the rehabilitation literature. The challenges and opportunities of applying small-N designs to enhance evidence-based rehabilitation are discussed.

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What Adherence Measures Should Be Used in Trials of Home-Based Rehabilitation Interventions? A Systematic Review of the Validity, Reliability, and Acceptability of Measures (2024)
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