Interventions to Improve Long-Term Adherence to Physical Rehabilitation: A Systematic Review.
Colleen A Burke, Katie J Seidler, Zachary D Rethorn and 14 others
PMID 38215396WHAT IT FOUND
Adjunct coaching, text messages, and booster sessions added to standard physical therapy did not improve long-term adherence to home exercise programs in chronic back or knee pain.
One text-message study showed a small benefit. The evidence is too thin to draw firm conclusions.
Key findings
01Across the included studies, no overall between-group difference was detected for adherence to home rehabilitation or for physical function.
02Three studies had evidence of a positive effect on adherence, but the certainty of evidence was rated low to very low.
03In the study rated low risk of bias that showed benefit, 24 weeks of automated text messages after the index program produced a mean difference of 3.1 points on a 0-to-24 adherence scale at 6 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Half the included studies did not have a priori focus on long-term adherence and were not designed to answer this question directly Most studies were underpowered to detect a difference, and adherence was not always the primary outcome Inadequate description of how interventions were delivered, deviations from intended delivery, and missing outcome data at longer time points Reliance on self-reported adherence measures, most of which were not validated Findings may not generalize to conditions other than chronic low back pain and hip or knee osteoarthritis (for example, post-surgical or acute-injury rehabilitation) Limited data on exclusively geriatric (65 and older) populations despite the median age in most studies being over 60
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the single positive text-message study as proof that adherence coaching works. The review found no overall between-group benefit, the included studies were underpowered, and the authors rate the evidence as low to very low certainty.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →