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Does a web-based exercise programming system improve home exercise adherence for people with musculoskeletal conditions? Randomized controlled trial
Bennell KL, Marshall CJ, Dobson F, Kasza J, Lonsdale C, Hinman RS
American Journal of Physical Medicine & Rehabilitation 2019 Apr 22:Epub ahead of print
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate whether a web-based exercise programming system improves adherence to a home exercise program for people with musculoskeletal conditions. DESIGN: Eligible patients with a musculoskeletal condition presenting to a physical therapist in private practice were randomised to: (1) control (home exercise prescribed by therapist's usual methods), or (2) intervention (home exercise prescribed using a web-based exercise programming system). The primary outcome was self-rated exercise adherence measured at week 3 via 11-point numeric rating scales (NRS). Secondary outcomes were satisfaction with exercise delivery and confidence in ability to undertake prescribed exercise. Process measures were also included. RESULTS: We enrolled 305 participants, with loss-to-follow-up of 14.5% (22/152) and 13.7% (21/153) in intervention and control groups, respectively. Compared with controls, the intervention group reported higher exercise adherence (mean difference NRS units (95% confidence intervals): adherence overall -1.0 (-1.6 to -0.3) and regarding number of exercises in session -0.7 (-1.3 to -0.1), number of repetitions -0.8 (-1.4 to -0.2) and number of sessions -1.0 (-1.6 to -0.3)). The intervention group showed greater confidence to exercise than control, with no difference in satisfaction. CONCLUSIONS: A web-based exercise programming system improved home exercise adherence and confidence in ability to undertake exercise, although the clinical relevance of the results needs to be established.

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