This systematic review aimed to estimate the effects of an additional digital intervention compared to no digital intervention on adherence to a prescribed home exercise program in people with a diagnosed clinical condition.
This was a systematic review of randomised controlled trails (RCTs). RCTs were included if their primary outcome was exercise adherence and participants in the trial received a prescription of home exercises for a specific clinical condition either with (intervention group) or without (control group) an additional digital intervention. Digital interventions included any intervention that was delivered through a communication platform or electronic device. One reviewer screened titles and two independent reviewers screened abstracts and full texts for inclusion. Risk of bias was assessed by two independent reviewers using the Cochrane Risk of Bias tool.
10 RCTs were included in the review involving 1,117 participants. 565 participants were randomised to the intervention group and 552 to the control group. Trial size varied from 20 to 152 participants and mean age ranged from 37.5 to 79.5 years. Trials were conducted in Australia, Europe, Asia, the Middle East, and North America. Clinical conditions included knee osteoarthritis, frozen shoulder, ankle sprain, flexor digitorium profundus repair, mixed musculoskeletal conditions, and stroke. Digital interventions included web interphases, text messages, phone calls, and phone-based applications. Follow-up adherence ranged from 2-weeks to 24-months, with a median of 17.9 weeks.
7 RCTs found that the addition of a digital intervention increased adherence to the home exercise program. The remaining 3 RCTs found no group differences. All studies reporting short-term follow-up (<6 weeks; 4 RCTs) and half of the studies reporting medium-term follow-up (8-12 weeks; 2 out of 4 RCTs) or long-term follow-up (24-months; 1 out of 2 RCTs) found positive effects of digital interventions on home exercise program adherence. Overall risk of bias of included studies was moderate to high.
Short-term adherence to home exercise programs may improve if prescribed with an additional digital intervention. Benefits in the longer-term are unclear.
Lang, S, McLelland, C, MacDonald, D & Hamilton, D 2022, “Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials” Archives of Physiotherapy, 12:24
PEDro acknowledges Sarah Wallwork for preparing the summary.