Are there different predictors of distinct exercise components?

Predictive factors of adherence to frequency and duration components in home exercise programs for neck and low back pain: an observational study

BACKGROUND

Evidence suggests that to facilitate physical activity sedentary people may adhere to one component of exercise prescriptions (intensity, duration or frequency) without adhering to other components. Some experts have provided evidence for determinants of adherence to different components among healthy people. However, our understanding remains scarce in this area for patients with neck or low back pain. The aims of this study are to determine whether patients with neck or low back pain have different rates of adherence to exercise components of frequency per week and duration per session when prescribed with a home exercise program, and to identify if adherence to both exercise components have distinct predictive factors.

METHODS

A cohort of one hundred eighty-four patients with chronic neck or low back pain who attended physiotherapy in eight primary care centers were studied prospectively one month after intervention. The study had three measurement periods: at baseline (measuring characteristics of patients and pain), at the end of physiotherapy intervention (measuring characteristics of the home exercise program) and a month later (measuring professional behaviors during clinical encounters, environmental factors and self-efficacy, and adherence behavior).

RESULTS

Adherence to duration per session (70.9% +/- 7.1) was more probable than adherence to frequency per week (60.7% +/- 7.0). Self-efficacy was a relevant factor for both exercise components (p < 0.05). The total number of exercises prescribed was predictive of frequency adherence (p < 0.05). Professional behaviors have a distinct influence on exercise components. Frequency adherence is more probable if patients received clarification of their doubts (adjusted OR: 4.1; p < 0.05), and duration adherence is more probable if they are supervised during the learning of exercises (adjusted OR: 3.3; p < 0.05).

CONCLUSION

We have shown in a clinic-based study that adherence to exercise prescription frequency and duration components have distinct levels and predictive factors. We recommend additional study, and advise that differential attention be given in clinical practice to each exercise component for improving adherence.

Social support for exercise by experts in older women post-hip fracture

Using the data of the Baltimore Hip Study 5 (a home-based exercise intervention), this study examined how social support for exercise by experts (SSE-E) affected the self-efficacy, outcome expectations, and exercise behavior among older women following a hip fracture. The total sample included 164 females aged 65 years (M = 81.0; SD = 6.9) who had surgical repair of a nonpathologic hip fracture. Model testing showed a direct relationship between SSE-E and outcome expectations for exercise. There was, however, no direct or indirect relationship between SSE-E and self-efficacy or exercise behavior. The positive effect of SSE-E on the outcome expectations for exercise in older women recovering from a hip fracture provides an opportunity for health care providers in improving physical activity in this population.

Lumbar stabilization: a review of core concepts and current literature, part 2

Lumbar-stabilization exercise programs have become increasingly popular as a treatment for low-back pain. In this article, we outline an evidence-based medicine approach to evaluating patients for a lumbar-stabilization program. We also discuss typical clinical components of this type of program and the rationale for including these particular features based on the medical literature.

[Prospective study of the relation between exercise performance for health promotion, self-efficacy, and outcome expectation of elderly people]

AIM

Self-efficacy and outcome expectation are psychological factors influencing performance behavior. Self-efficacy is a person's confidence that one can successfully perform the behavior to produce depend outcomes. Outcome expectation is the estimate that a favorable consequence will be produced by the behavior. These psychological factors are important reasons to perform exercise for health promotion among elderly people, but little is known about the relations among them. Therefor this study examined the relation among exercise for health promotion, self-efficacy, and outcome expectation of elderly people.

METHODS

This was a prospective study using self answered questionnaire. Data were collected from before and three follow-up investigations at 3 months intervals over a 9 month period. The sample was composed of 43 elderly people who applied for exercise program.

RESULTS

A strong correlation (r = 0.375 - r = 0.412) was observed between self-efficacy and exercise performance after three months. There was a strong correlation (r = 0.349 - r = 0.665) between outcome expectation and exercise performance at 3 months, 6 months, and 9 months.

CONCLUSION

These findings suggest that self-efficacy and outcome expectation are significant predictors of exercise performance for health promotion in elderly people.