Accuracy of self-reported home exercise adherence
Home exercise adherence is significantly overestimated using both exercise diaries and self-reported scales, as compared to accelerometer data. This the conclusion of a recent study that aimed to determine the validity of exercise diaries and self-reported scales for evaluating home exercise adherence compared to accelerometer data.
On top of that, both measures showed large variability between subjects; self-reporting also showed low test-retest reliability. Compared to accelerometer data, exercise journals and self-reporting seem to be inadequate measures of home exercise adherence.
Exercise is currently considered as the cornerstone in managing various musculoskeletal conditions. Given its cost-benefit, home exercise interventions are frequently prescribed to patients. However, adherence is a crucial factor in their effectiveness. The validity of adherence measures such as exercise diaries and self-reporting remains unclear.
Sixty participants over 45 years old with knee pain participated in the study. Participants were given a 12-week exercise program (5 times/ week; a total of 240 repetitions) and were regularly followed by a physiotherapist.
Exercise diaries and self-reported adherence were recorded. An accelerometer was concealed in the ankle weights provided. Participants were allowed to withdraw their data after being told of the accelerometer at the end of the 12 weeks.
Both the exercise diaries and self-reported showed significantly overestimated adherence compared with the accelerometer. Variability and reliability were also inadequate for measuring exercise adherence.
This study shows these measures are not recommended to evaluate adherence, especially not in a research context. Accelerometers are an increasingly available technology and can be easily incorporated in a variety of settings.
Expert opinion by José Pedro Correia
This study will be on your mind the next time you ask “So, Mr. X, did you do your exercises at home?” and get a “I most certainly did!” as a response (not that you were not suspicious already).
The findings show that despite the best intentions of both the therapist and the patient, the current most used measures of exercise adherence are not estimating adherence effectively.
> From: Nicolson et al., J Orthop Sports Phys Ther 27 (2018) 1-38 (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.