Barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions: A systematic review

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2025-02-05 DOI:10.1016/j.msksp.2025.103279

Hugo de Amorim , Marcos de Noronha , Jayden Hunter , Stephen Barrett , Michael Kingsley

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引用次数: 0

Abstract

Background

Exercise-based rehabilitation is the first line of treatment for people with musculoskeletal conditions. However, uptake and adherence are suboptimal, compromising the success of rehabilitation.

Objectives

To identify the barriers and facilitators that influence adherence to exercise-based rehabilitation in people with musculoskeletal conditions. Additionally, to identify the methods and instruments used to determine these barriers and facilitators.

Design

Systematic review

Methods

Five databases from inception to May 2024 using terms related to exercise, musculoskeletal conditions, methods, barriers and facilitators. Risk of bias was assessed using either the Newcastle-Ottawa Scale or Cochrane risk of bias tool. Using an inductive thematic approach, barriers and facilitators were grouped into intrapersonal, interpersonal and community factors. Methods/instruments were categorized into three groups, being questionnaires, interviews and focus-groups.

Results

Eighty-one of 8380 studies were included. The majority of studies were of good or fair quality (95%). The most frequently identified barriers were lack of time (53%), pain (45%) and health (40%). The most frequent facilitators were self-efficacy (42%), perceived health benefits (32%) and previous experiences (30%). The methods used were interviews (n = 53), questionnaires (n = 44) and focus groups (n = 10).

Conclusion

Most barriers and facilitators to exercise were related to intrapersonal factors. Although there is a lack of consistency in instruments used, the reported barriers and facilitators were similar across studies. Clinicians and researchers should consider intrapersonal factors when promoting exercise-based rehabilitation programs. Applying a theoretical framework to investigate barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions might assist practitioners to prioritize their practice.

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.