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Perceived barriers and facilitators to exercise adherence in osteoarthritis : A thematic synthesis of qualitative studies

Giardulli, Benedetto ; Marazzi, Davide ; Nespoli, Alessandro ; Leuzzi, Gaia ; Dell'Isola, Andrea LU ; Prior, Yeliz and Battista, Simone LU orcid (2025) In Osteoarthritis and Cartilage Open 7(2).
Abstract

Objective: Exercise is a first-line intervention for osteoarthritis (OA). However, exercise adherence remains low, and existing studies exploring factors influencing adherence have yielded inconclusive results based on quantitative data. This study aims to synthesise qualitative studies focused on the perceived facilitators and barriers affecting exercise adherence in individuals with OA. Design: A thematic synthesis of qualitative studies was conducted. Relevant articles were sourced from MEDLINE, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and PsychInfo until November 2024. Studies focused on adults (≥16 years) with hip or knee OA who had participated in exercise programmes to manage OA. The quality of the studies... (More)

Objective: Exercise is a first-line intervention for osteoarthritis (OA). However, exercise adherence remains low, and existing studies exploring factors influencing adherence have yielded inconclusive results based on quantitative data. This study aims to synthesise qualitative studies focused on the perceived facilitators and barriers affecting exercise adherence in individuals with OA. Design: A thematic synthesis of qualitative studies was conducted. Relevant articles were sourced from MEDLINE, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and PsychInfo until November 2024. Studies focused on adults (≥16 years) with hip or knee OA who had participated in exercise programmes to manage OA. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Data analysis followed Thematic Synthesis by Thomas & Harden to identify descriptive and analytical themes. The confidence of the evidence was evaluated through the Confidence in Evidence from Reviews of Qualitative Research (CERQual). Results: A total of 21 studies involving 458 participants were included. From seven descriptive themes, three analytical themes were developed: (i) Mind-Body Connection, (ii) Social Support Systems, and (iii) Environmental Enablers. These themes underscore the importance of personal beliefs, experiences, and mindsets, alongside social and environmental factors, in promoting or hindering exercise adherence. Conclusion: This study highlights the multifaceted cognitive, social, and environmental factors influencing exercise adherence in individuals with OA. The findings suggest that a ‘one-size-fits-all’ approach is insufficient for promoting sustained exercise engagement. Future quantitative research should build upon these insights to develop tailored strategies for enhancing exercise adherence in people with OA.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Physical therapy modalities, Physical therapy specialty, Qualitative research, Treatment adherence and compliance
in
Osteoarthritis and Cartilage Open
volume
7
issue
2
article number
100584
publisher
Elsevier
external identifiers
  • pmid:40061841
  • scopus:85217955779
ISSN
2665-9131
DOI
10.1016/j.ocarto.2025.100584
language
English
LU publication?
yes
id
629f7b1a-0b6a-4b1a-aec0-268092080b52
date added to LUP
2025-06-10 10:29:01
date last changed
2025-07-08 13:27:55
@article{629f7b1a-0b6a-4b1a-aec0-268092080b52,
  abstract     = {{<p>Objective: Exercise is a first-line intervention for osteoarthritis (OA). However, exercise adherence remains low, and existing studies exploring factors influencing adherence have yielded inconclusive results based on quantitative data. This study aims to synthesise qualitative studies focused on the perceived facilitators and barriers affecting exercise adherence in individuals with OA. Design: A thematic synthesis of qualitative studies was conducted. Relevant articles were sourced from MEDLINE, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and PsychInfo until November 2024. Studies focused on adults (≥16 years) with hip or knee OA who had participated in exercise programmes to manage OA. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Data analysis followed Thematic Synthesis by Thomas &amp; Harden to identify descriptive and analytical themes. The confidence of the evidence was evaluated through the Confidence in Evidence from Reviews of Qualitative Research (CERQual). Results: A total of 21 studies involving 458 participants were included. From seven descriptive themes, three analytical themes were developed: (i) Mind-Body Connection, (ii) Social Support Systems, and (iii) Environmental Enablers. These themes underscore the importance of personal beliefs, experiences, and mindsets, alongside social and environmental factors, in promoting or hindering exercise adherence. Conclusion: This study highlights the multifaceted cognitive, social, and environmental factors influencing exercise adherence in individuals with OA. The findings suggest that a ‘one-size-fits-all’ approach is insufficient for promoting sustained exercise engagement. Future quantitative research should build upon these insights to develop tailored strategies for enhancing exercise adherence in people with OA.</p>}},
  author       = {{Giardulli, Benedetto and Marazzi, Davide and Nespoli, Alessandro and Leuzzi, Gaia and Dell'Isola, Andrea and Prior, Yeliz and Battista, Simone}},
  issn         = {{2665-9131}},
  keywords     = {{Physical therapy modalities; Physical therapy specialty; Qualitative research; Treatment adherence and compliance}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage Open}},
  title        = {{Perceived barriers and facilitators to exercise adherence in osteoarthritis : A thematic synthesis of qualitative studies}},
  url          = {{http://dx.doi.org/10.1016/j.ocarto.2025.100584}},
  doi          = {{10.1016/j.ocarto.2025.100584}},
  volume       = {{7}},
  year         = {{2025}},
}