Evde Egzersiz Programlarına Uyum: Demografik ve Klinik Faktörlerin Etkisi

Year 2025, Volume: 9 Issue: 2, 299 - 305, 31.08.2025

Gulsah Karataş , Şengül Metin Tarhan Çağnur Elpen Kodaz , Fatih Karataş , Rıfat Tarhan

https://doi.org/10.29058/mjwbs.1758374

Abstract

Amaç: Bu çalışmanın amacı, fiziksel tıp ve rehabilitasyon alan hastaların evde egzersiz programlarına ne kadar iyi uyduklarını araştırmak
ve hangi demografik ve klinik faktörlerin uyum düzeylerini etkileyebileceğini daha iyi anlamaktır.
Gereç ve Yöntemler: Bu prospektif gözlemsel çalışmada, standart bir ev egzersiz programı reçete edilen 296 hasta takip edilmiştir. Yaş,
eğitim, meslek, ağrı şiddeti (VAS ile ölçülmüştür) ve egzersiz planına uyum hakkında bilgiler toplanmış ve istatistiksel olarak analiz edilmiştir.
Bulgular: Katılımcılar arasında 154 kişi (%52) reçete edilen ev egzersiz rutinlerini düzenli olarak takip etmiştir. Genel olarak, hastaların
%68,2'si ağrı düzeylerinde gözle görülür bir azalma olduğunu bildirmiştir. Programa sürekli uyanlar, uymayanlara kıyasla önemli ölçüde daha
fazla ağrı kesici deneyimlemiştir (p < 0.001). Uyumun hem eğitim düzeyinden hem de meslekten etkilendiği görülmektedir. Daha yüksek
eğitim düzeyine sahip hastaların egzersiz rutinlerini takip etme olasılığı daha yüksekken, çalışanlar, emekliler ve öğrenciler gibi bireyler
daha güçlü uyum kalıpları göstermiştir (sırasıyla p = 0.002 ve p = 0.019). Buna karşılık, ev hanımları ve daha düşük eğitim düzeyine sahip
bireylerin egzersiz programlarına bağlı kalma olasılıkları daha düşüktü; genellikle ev sorumluluklarını düzenli katılımın önündeki bir engel
olarak göstermişlerdir.
Sonuç: Evde uygulanan egzersiz programlarına bağlı kalmak, özellikle ağrıyı daha hızlı ve etkili bir şekilde azaltma söz konusu olduğunda,
sonuçlarda gerçek bir fark yaratıyor gibi görünmektedir. Bu bulgular, özellikle kas-iskelet sistemi rehabilitasyonunda hastaların programa
bağlı kalmasına yardımcı olmak için, muhtemelen teknolojiyi kullanarak, bireye özel destek sistemleri tasarlamanın önemini vurgulamaktadır

Keywords

Evde uygulanan egzersiz programları , Uyum , Ağrı , Fiziksel tıp

Adherence to Home Exercise Programs: The Impact of Demographic and Clinical Factors

Abstract

Aim: This study aimed to explore how well patients receiving physical medicine and rehabilitation adhered to home-based exercise programs,
and to better understand which demographic and clinical factors might influence their level of adherence.
Material and Methods: In this prospective observational study, 296 patients who had been prescribed a standardized home exercise
program were followed. Information on age, education, occupation, pain severity (measured by VAS), and adherence to the exercise plan
was collected and statistically analyzed Results: Among the participants, 154 individuals (52%) were regularly following their prescribed home exercise routines. Overall, 68.2%
of patients reported a noticeable reduction in pain levels. Notably, those who consistently adhered to the program experienced significantly
more pain relief compared to those who were non-adherent (p < 0.001). Adherence appeared to be influenced by both education level and
occupation. Patients with higher levels of education were more likely to follow their exercise routines, while individuals such as workers,
retirees, and students demonstrated stronger adherence patterns (p = 0.002 and p = 0.019, respectively). In contrast, housewives and
individuals with lower educational attainment were less likely to stay committed—often citing household responsibilities as a barrier to regular
participation.
Conclusion: Sticking to home-based exercise programs seems to make a real difference in outcomes, especially when it comes to reducing
pain more quickly and effectively. These findings emphasize the importance of designing support systems that are tailored to the individual—
possibly using technology to help patients stay on track, particularly in musculoskeletal rehabilitation.

Keywords

Home-based exercise programs , Adherence , Pain , Physical medicine

References

• 1. Hayden JA, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev. 2005 Jul 20;2005(3):CD000335. doi: 10.1002/14651858.CD000335.pub2. PMID: 16034851; PMCID: PMC10068907.
• 2. Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24. PMID: 26405113.
• 3. Peek, K., Carey, M., Sanson-Fisher, R., & Mackenzie, L. (2017). Physiotherapists' perceptions of patient adherence to prescribed self-management strategies: A cross-sectional survey of Australian physiotherapists. Disability and Rehabilitation, 39(19), 1932–1938. https://doi.org/10.1080/09638288.2016.12 12281
• 4. Pinelli, E., Barone, G., Benvenuti, F., Audino, G., Zinno, R., & Bragonzoni, L. (2021). Home-based exercise program for women with osteoporosis: Focus on adherence. European Journal of Public Health, 31(Suppl 3), ckab165.415. https://doi. org/10.1093/eurpub/ckab165.415
• 5. Essery R, Geraghty AW, Kirby S, Yardley L. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil. 2017 Mar;39(6):519-534. doi: 10.3109/09638288.2016.1153160. Epub 2016 Apr 21. PMID: 27097761.
• 6. Ainsworth, M. C., Rogers, L. Q., Perumean-Chaney, S. E., Thirumalai, M., Brown, N., Jackson, E. A., ... & Pekmezi, D. (2020). Effects of interactive voice response (IVR) counseling on physical activity benefits and barriers. Health Behavior and Policy Review, 7(5), 407–415.
• 7. Lang S, McLelland C, MacDonald D, Hamilton DF. Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials. Arch Physiother. 2022 Oct 3;12(1):24. doi: 10.1186/s40945-022- 00148-z. PMID: 36184611; PMCID: PMC9527092.
• 8. Collado-Mateo D, Lavín-Pérez AM, Peñacoba C, Del Coso J, Leyton-Román M, Luque-Casado A, Gasque P, Fernández- Del-Olmo MÁ, Amado-Alonso D. Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. Int J Environ Res Public Health. 2021 Feb 19;18(4):2023. doi: 10.3390/ ijerph18042023. PMID: 33669679; PMCID: PMC7922504.
• 9. Doherty C, Lambe R, O'Grady B, O'Reilly-Morgan D, Smyth B, Lawlor A, Hurley N, Tragos E. An Evaluation of the Effect of App-Based Exercise Prescription Using Reinforcement Learning on Satisfaction and Exercise Intensity: Randomized Crossover Trial. JMIR Mhealth Uhealth. 2024 Nov 26;12:e49443. doi: 10.2196/49443. PMID: 39622712; PMCID: PMC11612604.
• 10. Jordan JL, Holden MA, Mason EE, Foster NE. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD005956. doi: 10.1002/14651858.CD005956. pub2. PMID: 20091582; PMCID: PMC6769154.
• 11. Kanavaki AM, Rushton A, Efstathiou N, Alrushud A, Klocke R, Abhishek A, Duda JL. Barriers and facilitators of physical activity in knee and hip osteoarthritis: a systematic review of qualitative evidence. BMJ Open. 2017 Dec 26;7(12):e017042. doi: 10.1136/bmjopen-2017-017042. PMID: 29282257; PMCID: PMC5770915.
• 12. Petrosyan H, Leonardi C, Thakral A, Roth J, Russoniello N, Goldin Y, Parikh S. Barriers and factors associated with adherence to a home exercise program of adults with musculoskeletal pain. J Back Musculoskelet Rehabil. 2024;37(2):473-485. doi: 10.3233/BMR-230178. PMID: 38108342.
• 13. Macías-Hernández SI, Loya-García F, Zepeda-Mora R, Nava- Bringas TI, Morones-Alba JD. Disease-related factors associated with exercise adherence in postmenopausal women with osteoporosis. J Frailty Sarcopenia Falls. 2020 Sep 1;5(3):72- 78. doi: 10.22540/JFSF-05-072. PMID: 32885104; PMCID: PMC7461352.
• 14. Himler P, Lee GT, Rhon DI, Young JL, Cook CE, Rentmeester C. Understanding barriers to adherence to home exercise programs in patients with musculoskeletal neck pain. Musculoskelet Sci Pract. 2023 Feb;63:102722. doi: 10.1016/j.msksp. 2023.102722. Epub 2023 Jan 21. PMID: 36709090.
• 15. Escolar-Reina P, Medina-Mirapeix F, Gascón-Cánovas JJ, Montilla-Herrador J, Jimeno-Serrano FJ, de Oliveira Sousa SL, del Baño-Aledo ME, Lomas-Vega R. How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study. BMC Health Serv Res. 2010 Mar 10;10:60. doi: 10.1186/1472-6963- 10-60. PMID: 20219095; PMCID: PMC2847560.
• 16. Yalew, H. S., et al. (2022). Adherence to home-based exercise program and its predictors among patients with chronic musculoskeletal disorders. Patient Preference and Adherence, 16, 1113–1124. https://doi.org/10.2147/PPA.S346680
• 17. Arensman RM, Pisters MF, Kloek CJJ, Koppenaal T, Veenhof C, Ostelo RJWG. Exploring the association between adherence to home-based exercise recommendations and recovery of nonspecific low back pain: a prospective cohort study. BMC Musculoskelet Disord. 2024 Aug 1;25(1):614. doi: 10.1186/s12891-024-07705-6. PMID: 39090661; PMCID: PMC11292889.
• 18. Höher J, Lischke B, Petersen W, Mengis N, Niederer D, Stein T, Stoffels T, Prill R, Schmidt-Lucke C. Sensor-based telerehabilitation system increases patient adherence after knee surgery. PLOS Digit Health. 2023 Feb 17;2(2):e0000175. doi: 10.1371/journal.pdig.0000175. PMID: 36812639; PMCID: PMC9937459.
• 19. Sumner J, Lim HW, Chong LS, Bundele A, Mukhopadhyay A, Kayambu G. Artificial intelligence in physical rehabilitation: A systematic review. Artif Intell Med. 2023 Dec;146:102693. doi: 10.1016/j.artmed.2023.102693. Epub 2023 Nov 2. PMID: 38042593.
• 20. Abedi A, Colella TJF, Pakosh M, Khan SS. Artificial intelligence- driven virtual rehabilitation for people living in the community: A scoping review. NPJ Digit Med. 2024 Feb 3;7(1):25. doi: 10.1038/s41746-024-00998-w. PMID: 38310158; PMCID: PMC10838287.