Description
In a recent talk, John Room, the vice chair of the ATOCP, introduced Dr. Pip Nicolson, who is a Versus Arthritis Foundation fellow and based in the Nuffield Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences. Dr. Nicolson discussed the complex topic of exercise adherence in orthopedics, particularly focusing on patients with knee osteoarthritis. Throughout her presentation, she acknowledged the challenges faced by patients in adhering to prescribed exercise regimes, emphasizing that adherence is multifaceted and requires significant behavior changes.
Dr. Nicolson highlighted research indicating that adherence to exercise tends to decline significantly over time, especially in the first six months, raising concerns about the long-term benefits of prescribed exercise programs. She explored distinct trajectories of adherence among patients, identifying three main patterns: gradual decline, sharp drop-off, and consistent low engagement from the start. The importance of identifying factors influencing adherence was emphasized, as they can vary by individual and over time.
Additionally, she shared insights into barriers and facilitators of exercise adherence based on qualitative studies, stressing that behavioral theories should inform practice. Dr. Nicolson proposed that physiotherapists should focus on building rapport with patients, setting specific goals, providing ongoing encouragement, and utilizing technology such as apps or accelerometers to improve adherence.
In a lively Q&A session, both clinicians evaluated their roles in promoting exercise adherence and how surgical teams can contribute by reinforcing the importance of exercises in recovery. Dr. Nicolson cited the need for tailored approaches in patient interactions and encouraged a collaborative dialogue about expectations and goals in rehabilitation. Ultimately, she underscored the complexity of behavior change in exercise adherence and the necessity for ongoing support and individualized strategies.