Behaviour change interventions associated with exercise adherence in patients with persistent musculoskeletal pain: systematic review

Abstract

Background. Persistent musculoskeletal (MSK) pain is the leading cause of disability worldwide affecting upwards of 30% of the population. Exercise has positive results on patient outcomes however long term adherence rates are low, eliminating many of the benefits, particularly in patients with persistent MSK pain. There is a lack of research designed to enhance exercise adherence in this population. Psychological interventions can promote behaviour change and adherence, however appropriate theoretical models should be applied with constructs that target the relevant behaviours. The primary aim of this systematic review is to identify behavioural interventions associated with exercise adherence in patients with persistent musculoskeletal pain. Methods. The following databases were searched: Embase, PsychINFO, MEDLINE, CINAHL and the Cochrane Central Register of Controlled Trials. Data were extracted and assessed for methodological quality by two independent reviewers using the Cochrane risk of bias tool. Expected results. Preliminary results identified eight studies, including 1,113 participants, meeting the inclusion criteria. Over 20 behaviour change techniques (BCTs coded using the Behaviour Change Taxonomy V18) have been identified, with multiple measures of exercise adherence. Current stage of work. Data is currently being coded and analysed using the Theory Coding Scheme and Behaviour Change Taxonomy. Effect sizes will be analysed using RevMan 5.3. Discussion. In order to develop effective interventions for patients experiencing persistent musculoskeletal pain the effectiveness of various BCTs needs to be explored. The identification of effective interventions linked to theoretical constructs may enhance exercise adherence, and provide a better standard of care.