Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy and Selection of Studies
2.2. Data Extraction
2.3. Data Synthesis
- Characteristics of the exercise program, that would comprise those factors related to how the physical exercise is planned, including the individualization, the evidence-based settings, and other characteristics such as frequency, duration, intensity, or volume.
- Involvement of professionals from different disciplines, that would be related to the convenience of including experts or methods from different disciplines.
- Supervision, which would include the significance or irrelevance of supervising the exercise interventions.
- Technology, which would be focused on the potential additional benefits or disadvantages of including technological devices and applications to conduct the physical exercise intervention.
- Initial exploration of participant’s characteristics, barriers, and facilitators, which would include the identification of relevant variables of the patients before the exercise interventions that could reduce or increase the adherence to exercise.
- Participants’ education, adequate expectations, and knowledge about risks and benefits, which would be related to what the participants know or learn about the relevance of physical exercise for their own health so that the expectations about the improvements were not inaccurate.
- Enjoyment and absence of unpleasant experiences, which would be related to the pleasure obtained while exercising and also by the absence of pain or discomfort.
- Integration in daily living, which includes the consideration of the participant’s preferences and background to adapt the exercise characteristics and settings.
- Social support and relatedness, which includes support from peers, staff, and family, as well as the establishment of positive social interactions and feelings of belonging to a group.
- Communication and feedback, which is related to the effective interaction between the staff and the participant.
- Available progress information and monitoring, providing enough information to the patient so that they can be aware of the changes and improvements from objective data.
- Self-efficacy and competence, which is related to the participant’s perception of what they can do and what they will be able to do.
- Participant’s active role, which would include self-management, self-control, self-monitoring, autonomy, and empowerment.
- Goal setting, which is related to the establishment of adequate objectives.
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Outcome Results
4. Discussion
4.1. Design of the Exercise Intervention
4.2. Multidisciplinary Team
4.3. Supervision during the Exercise Sessions
4.4. The Use of Technology
4.5. Initial Exploration of Participant’s Characteristics, Barriers, and Facilitators
4.6. Participants Education, Adequate Expectations, and Knowledge about Risks and Benefits
4.7. Enjoyment and Absence of Unpleasant Experiences
4.8. Integration in Daily Living
4.9. Social Support and Relatedness
4.10. Communication and Feedback
4.11. Available Progress Information and Monitoring
4.12. Self-Efficacy and Competence
4.13. Participant’s Active Role
4.14. Goal Setting
4.15. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients Characteristics | Number of Studies | Type of Exercise Interventions Revised | |
---|---|---|---|
Cancer | Cancer patients or survivors | 4 | Home-based: 1 review Any: 6 reviews |
Advanced cancer | 1 | ||
Non-small cell lung cancer | 1 | ||
Colorectal cancer | 1 | ||
Cardiovascular disease | Heart failure | 2 | Center-based: 1 review Any: 6 reviews |
Under cardiac rehabilitation program | 4 | ||
General cardiovascular conditions | 1 | ||
Older adults | Falls prevention | 3 | Center-based: 2 review Home-based: 1 review Any: 5 reviews |
Healthy elderly | 5 | ||
Musculoskeletal disorders | Low back pain | 1 | Center-based: 1 review Home-based: 1 review Any: 10 reviews |
Arthritis | 3 | ||
Osteoporosis/osteopenia | 1 | ||
General/multiple musculoskeletal pain or chronic conditions | 7 | ||
Obesity or weight loss | 3 | Center-based: 3 review | |
Intermittent claudication | 2 | Center-based: 1 review Any: 1 review | |
Mild cognitive impairment and dementia | 2 | Center-based: 1 review Any: 1 review | |
Parkinson | 1 | Any: 1 review | |
Type 2 diabetes | 1 | Any: 1 review | |
Solid-organ transplant candidates | 1 | Any: 1 review | |
Under vestibular rehabilitation | 1 | Home-based: 1 review | |
Different chronic diseases | 6 | Center-based: 1 review Home-based: 2 reviews Any: 3 reviews | |
Exercise Referral schemes | 4 | Center-based: 2 reviews Any: 2 reviews |
Key Factors | Sub-Key Factors | Number of Reviews Including Each Key Factor | |||||
---|---|---|---|---|---|---|---|
Total | Cancer | CVD | Musculo-Skeletal Disorders | Older Adults | Obesity/Weight Loss | ||
Exercise characteristics design | Characteristics of the exercise are individualized and scientifically correct | 23 | 3 | 3 | 4 | 4 | 2 |
The duration of the exercise intervention is not too long | 10 | - | 1 | 1 | 3 | 1 | |
Multidisciplinarity | Multidisciplinary program | 12 | - | 1 | 5 | 2 | 2 |
Supervision | Supervision | 17 | 1 | 1 | 4 | 4 | 1 |
Technology | Use of adequate technology | 12 | - | 3 | 1 | 3 | 1 |
Initial exploration of participant’s characteristics, barriers, and facilitators | Previous habits and physical and mental health status of the participants are known | 36 | 7 | 6 | 5 | 2 | 3 |
Barriers and facilitators are explored before the exercise program is delivered to search for alternatives | 29 | 5 | 6 | 5 | 3 | 2 | |
Participants education, adequate expectations, and knowledge about risks and benefits | Participants are educated about physical exercise in their condition | 17 | 2 | 4 | 3 | 2 | 1 |
Participants are adequately informed about the risks and benefits of the program | 15 | - | 3 | 1 | 4 | 1 | |
Adequate expectations | 15 | - | 3 | 3 | 3 | 1 | |
Enjoyment and absence of unpleasant experiences | Enjoyment | 10 | - | 1 | 3 | 2 | 1 |
Absence of unpleasant experiences | 9 | 1 | - | 3 | 1 | 1 | |
Integration in daily living | Participant’s preferences and background are considered in the program to enhance its integration into their lifestyle | 29 | 3 | 2 | 5 | 5 | 3 |
Good accessibility, adequate place, and flexibility in the schedule | 21 | 4 | 3 | 3 | 4 | 2 | |
Social support and relatedness | Social support from peers and family | 22 | 1 | 5 | 4 | 3 | 1 |
Social support from the professional | 22 | 2 | 3 | 5 | 2 | 1 | |
Relatedness | 11 | - | 2 | 2 | 3 | - | |
Communication and feedback | Intra-session feedback | 11 | 2 | 2 | 3 | 2 | 1 |
Bilateral and fluid communication with the staff | 16 | - | 2 | 3 | 3 | 1 | |
Available progress information and monitoring | Objective information for patients to know their progress | 17 | 1 | 3 | 2 | 5 | 2 |
Exercise is monitored | 16 | 2 | 4 | - | 3 | 2 | |
Self-efficacy and competence | Self-efficacy | 21 | 2 | 3 | 3 | 3 | 2 |
Competence | 7 | - | 3 | - | 1 | - | |
Participant’s active role | Self-management, self-control, and self-monitoring | 16 | 1 | 3 | 4 | 1 | - |
Autonomy and empowerment | 8 | - | 1 | 1 | 2 | - | |
Goal setting | Objectives are clear and established with the patient | 12 | 1 | 2 | 5 | - | 2 |
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Collado-Mateo, D.; Lavín-Pérez, A.M.; Peñacoba, C.; Del Coso, J.; Leyton-Román, M.; Luque-Casado, A.; Gasque, P.; Fernández-del-Olmo, M.Á.; Amado-Alonso, D. Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. Int. J. Environ. Res. Public Health 2021, 18, 2023. https://doi.org/10.3390/ijerph18042023
Collado-Mateo D, Lavín-Pérez AM, Peñacoba C, Del Coso J, Leyton-Román M, Luque-Casado A, Gasque P, Fernández-del-Olmo MÁ, Amado-Alonso D. Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. International Journal of Environmental Research and Public Health. 2021; 18(4):2023. https://doi.org/10.3390/ijerph18042023
Chicago/Turabian StyleCollado-Mateo, Daniel, Ana Myriam Lavín-Pérez, Cecilia Peñacoba, Juan Del Coso, Marta Leyton-Román, Antonio Luque-Casado, Pablo Gasque, Miguel Ángel Fernández-del-Olmo, and Diana Amado-Alonso. 2021. "Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review" International Journal of Environmental Research and Public Health 18, no. 4: 2023. https://doi.org/10.3390/ijerph18042023