Araştırma Makalesi
BibTex RIS Kaynak Göster

Kronik bel ve boyun ağrılı bireylerde farklı egzersiz süpervizyon yöntemlerinin egzersiz uyumuna etkisi

Yıl 2025, Cilt: 12 Sayı: 3, 154 - 164, 30.12.2025
https://doi.org/10.15437/jetr.1764761

Öz

Amaç: Bu çalışma, kronik bel ve boyun ağrısı olan bireylerde farklı egzersiz eğitim yaklaşımlarının egzersize uyuma etkisini araştırmak amacıyla yapıldı.
Yöntem: Toplam 519 hasta, kapalı zarf yöntemiyle ev egzersizi programı, fizyoterapist eşliğinde egzersiz ve takipli ev programı olmak üzere üç gruba ayrıldı. Çalışmada ev egzersiz programı grubuna tanıya özgü egzersiz broşürleri verildi. Fizyoterapist eşliğinde egzersiz grubunda egzersizler tedavi süresince birebir uygulandı. Takipli ev programı grubuna ise egzersiz eğitimi sonrası günlük kısa mesaj (SMS) ile egzersiz hatırlatmaları yapıldı. Tüm hastalara 10 seans geleneksel fizik tedavi uygulandı. Ardından her gruba farklı egzersiz eğitimleri verildi. Klinik değerlendirme için Oswestry Özürlülük İndeksi (ODI) ve Boyun Özürlülük İndeksi (NDI)’nden faydalanıldı. Egzersiz uyumu, araştırmacılar tarafından geliştirilen 5 maddelik bir form ile memnuniyet ise 0-100 skalası ile ölçüldü. Değerlendirmeler tedavi öncesi, sonrası ve 3. ayda yapıldı.
Bulgular: Egzersizlerin doğruluğu takipli ev programı grubunda en yüksek, ev egzersiz grubunda ise en düşük bulundu (p<0,05). Fizyoterapist eşliğindeki grup, ev egzersizi grubuna göre anlamlı olarak daha iyi uyum gösterdi (p<0,05). Memnuniyet düzeyleri tüm gruplarda benzerdi (p>0,05).
Sonuç: Egzersiz uyumunu artırmak için egzersizlerin fizyoterapistler tarafından detaylı anlatılması ve takipli sistemlerin (SMS gibi) kullanılması önerilmektedir. Elde edilen bu sonuçlar, klinik uygulamalarda hasta eğitimi ve takibinin egzersiz uyumuna katkısını desteklemektedir.

Etik Beyan

Hasan Kalyoncu Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulu tarafından 03.05.2021 tarihinde 2021/063 numarası ile onaylandı ve ClinicalTrials.gov platformunda (NCT05851495) kayıt altına alındı.

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

  • Brooks PM. The burden of musculoskeletal disease: a global perspective. Clin Rheumatol. 2006;25:778-781.
  • Krismer M, van Tulder M. Low back pain (non- specific). Best Pract Res Clin Rheumatol. 2007;21:77-91.
  • Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391:2356-2367.
  • Hoy DG, Smith E, Cross M, et al. Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the Global Burden of Disease 2010 Study and the next steps forward. Ann Rheum Dis. 2015;74:4-7.
  • Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15:834-848.
  • Hoy D, March L, Woolf A, et al. The global burden of neck pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:1309-1315.
  • Popescu A, Lee H. Neck pain and lower back pain. Med Clin North Am. 2020;104:279-292.
  • Sabaté E, ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva: World Health Organization; 2003.
  • Takasaki H, Kawazoe S, Miki T, et al. Development and validity assessment of a Japanese version of the Exercise Adherence Rating Scale in participants with musculoskeletal disorders. Health Qual Life Outcomes. 2021;19:169.
  • Hall AM, Kamper SJ, Hernon M, et al. Measurement tools for adherence to non- pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review. Arch Phys Med Rehabil. 2015;96:552- 562.
  • Newman-Beinart NA, Norton S, Dowling D, et al. The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS). Physiotherapy. 2017;103:180-185.
  • Jansons PS, Haines TP, O’Brien L. Interventions to achieve ongoing exercise adherence for adults with chronic health conditions who have completed a supervised exercise program: systematic review and meta-analysis. Clin Rehabil. 2017;31:465-477.
  • Yakut E, Düger T, Oksüz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004;29:581-585.
  • Telci EA, Karaduman A, Yakut Y, et al. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009;34:1732-1735.
  • Dhondt E, Van Oosterwijck J, Cagnie B, et al. Predicting treatment adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain. J Back Musculoskelet Rehabil. 2020;33:277-293.
  • Kolt GS, Brewer BW, Pizzari T, et al. The sport injury rehabilitation adherence scale: a reliable scale for use in clinical physiotherapy. Physiotherapy. 2007;93:17-22.
  • Altuntaş O, Ünlüer NÖ, Özdemir O, et al. Adherence to home exercise program in patients with low back pain. J Exerc Ther Rehabil. 2020;7:12-18.
  • Jones MD, Hansford HJ, Bastianon A, et al. Exercise adherence is associated with improvements in pain intensity and functional limitations in adults with chronic non-specific low back pain: a secondary analysis of a Cochrane review. J Physiother. 2025;71:91-99.
  • Areerak K, Waongenngarm P, Janwantanakul P. Factors associated with exercise adherence to prevent or treat neck and low back pain: a systematic review. Musculoskelet Sci Pract. 2021;52:102333.
  • L’Heureux J, Coutu MF, Berbiche D, et al. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. Eur J Physiother. 2020;22:299-308.
  • Hörder H, Nero H, Misini Ignjatovic M, et al. Digitally delivered exercise and education treatment program for low back pain:longitudinal observational cohort study. JMIR Rehabil Assist Technol. 2022;9:e38084.
  • Hou J, Yang R, Yang Y, et al. The effectiveness and safety of utilizing mobile phone–based programs for rehabilitation after lumbar spinal surgery: multicenter, prospective randomized controlled trial. JMIR MHealth UHealth. 2019;7:e10201.
  • Palazzo C, Klinger E, Dorner V, et al. Barriers to home-based exercise program adherence with chronic low back pain: patient expectations regarding new technologies. Ann Phys Rehabil Med. 2016;59:107-113.
  • Lilje SC, Olander E, Berglund J, et al. Experiences of older adults with mobile phone text messaging as reminders of home exercises after specialized manual therapy for recurrent low back pain: a qualitative study. JMIR MHealth UHealth. 2017;5:e39.
  • Gialanella B, Comini L, Olivares A, et al. Pain, disability and adherence to home exercises in patients with chronic neck pain: long-term effects of phone surveillance a randomized controlled study. Eur J Phys Rehabil Med. 2020;56:120-128.
  • Escolar-Reina P, Medina-Mirapeix F, Gascón- Cánovas JJ, et al. 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;10:60.

Effects of different exercise supervision methods on exercise adherence in individuals with chronic back and neck pain

Yıl 2025, Cilt: 12 Sayı: 3, 154 - 164, 30.12.2025
https://doi.org/10.15437/jetr.1764761

Öz

Purpose: This study aimed to investigate the effects of different exercise training approaches on exercise adherence in individuals with chronic low back and neck pain.
Methods: A total of 519 patients were randomly assigned, using a sealed-envelope method, into three groups: home-based exercise groups, physiotherapist-led groups, and home-based follow up groups. In the home-based exercise groups, diagnosis- specific exercise brochures were provided. In the physiotherapist-led groups, exercises were demonstrated and performed one- on-one under physiotherapist supervision throughout the treatment period. In home-based follow up groups, daily text message (SMS) reminders were sent following exercise training. All participants received 10 sessions of conventional physical therapy, followed by the assigned exercise training protocol. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and the Neck Disability Index (NDI). Exercise adherence was evaluated using a five-item form developed by the researchers, and satisfaction was measured on a 0–100 scale. Assessments were conducted at baseline, post-treatment, and at the third-month follow-up.
Results: Exercise accuracy was highest in the home-based follow up groups and lowest in the home-based exercise groups (p<0.05). The physiotherapist-led groups demonstrated significantly greater adherence compared to the home-based exercise groups (p<0.05). Satisfaction levels were comparable across all groups (p > 0.05).
Conclusion: Detailed instruction by physiotherapists and the use of monitoring systems (e.g., SMS reminders) are recommended to improve exercise adherence. These findings support the role of structured patient education and follow-up in enhancing exercise compliance in clinical practice.

Kaynakça

  • Brooks PM. The burden of musculoskeletal disease: a global perspective. Clin Rheumatol. 2006;25:778-781.
  • Krismer M, van Tulder M. Low back pain (non- specific). Best Pract Res Clin Rheumatol. 2007;21:77-91.
  • Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391:2356-2367.
  • Hoy DG, Smith E, Cross M, et al. Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the Global Burden of Disease 2010 Study and the next steps forward. Ann Rheum Dis. 2015;74:4-7.
  • Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15:834-848.
  • Hoy D, March L, Woolf A, et al. The global burden of neck pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:1309-1315.
  • Popescu A, Lee H. Neck pain and lower back pain. Med Clin North Am. 2020;104:279-292.
  • Sabaté E, ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva: World Health Organization; 2003.
  • Takasaki H, Kawazoe S, Miki T, et al. Development and validity assessment of a Japanese version of the Exercise Adherence Rating Scale in participants with musculoskeletal disorders. Health Qual Life Outcomes. 2021;19:169.
  • Hall AM, Kamper SJ, Hernon M, et al. Measurement tools for adherence to non- pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review. Arch Phys Med Rehabil. 2015;96:552- 562.
  • Newman-Beinart NA, Norton S, Dowling D, et al. The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS). Physiotherapy. 2017;103:180-185.
  • Jansons PS, Haines TP, O’Brien L. Interventions to achieve ongoing exercise adherence for adults with chronic health conditions who have completed a supervised exercise program: systematic review and meta-analysis. Clin Rehabil. 2017;31:465-477.
  • Yakut E, Düger T, Oksüz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004;29:581-585.
  • Telci EA, Karaduman A, Yakut Y, et al. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009;34:1732-1735.
  • Dhondt E, Van Oosterwijck J, Cagnie B, et al. Predicting treatment adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain. J Back Musculoskelet Rehabil. 2020;33:277-293.
  • Kolt GS, Brewer BW, Pizzari T, et al. The sport injury rehabilitation adherence scale: a reliable scale for use in clinical physiotherapy. Physiotherapy. 2007;93:17-22.
  • Altuntaş O, Ünlüer NÖ, Özdemir O, et al. Adherence to home exercise program in patients with low back pain. J Exerc Ther Rehabil. 2020;7:12-18.
  • Jones MD, Hansford HJ, Bastianon A, et al. Exercise adherence is associated with improvements in pain intensity and functional limitations in adults with chronic non-specific low back pain: a secondary analysis of a Cochrane review. J Physiother. 2025;71:91-99.
  • Areerak K, Waongenngarm P, Janwantanakul P. Factors associated with exercise adherence to prevent or treat neck and low back pain: a systematic review. Musculoskelet Sci Pract. 2021;52:102333.
  • L’Heureux J, Coutu MF, Berbiche D, et al. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. Eur J Physiother. 2020;22:299-308.
  • Hörder H, Nero H, Misini Ignjatovic M, et al. Digitally delivered exercise and education treatment program for low back pain:longitudinal observational cohort study. JMIR Rehabil Assist Technol. 2022;9:e38084.
  • Hou J, Yang R, Yang Y, et al. The effectiveness and safety of utilizing mobile phone–based programs for rehabilitation after lumbar spinal surgery: multicenter, prospective randomized controlled trial. JMIR MHealth UHealth. 2019;7:e10201.
  • Palazzo C, Klinger E, Dorner V, et al. Barriers to home-based exercise program adherence with chronic low back pain: patient expectations regarding new technologies. Ann Phys Rehabil Med. 2016;59:107-113.
  • Lilje SC, Olander E, Berglund J, et al. Experiences of older adults with mobile phone text messaging as reminders of home exercises after specialized manual therapy for recurrent low back pain: a qualitative study. JMIR MHealth UHealth. 2017;5:e39.
  • Gialanella B, Comini L, Olivares A, et al. Pain, disability and adherence to home exercises in patients with chronic neck pain: long-term effects of phone surveillance a randomized controlled study. Eur J Phys Rehabil Med. 2020;56:120-128.
  • Escolar-Reina P, Medina-Mirapeix F, Gascón- Cánovas JJ, et al. 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;10:60.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Fizyoterapi, Dijital Sağlık
Bölüm Araştırma Makalesi
Yazarlar

İrfan Küçükoğlu 0000-0003-3038-5880

Kezban Bayramlar 0000-0002-6760-2175

Yavuz Yakut 0000-0001-9363-0869

Gönderilme Tarihi 15 Ağustos 2025
Kabul Tarihi 18 Kasım 2025
Yayımlanma Tarihi 30 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 12 Sayı: 3

Kaynak Göster

Vancouver Küçükoğlu İ, Bayramlar K, Yakut Y. Kronik bel ve boyun ağrılı bireylerde farklı egzersiz süpervizyon yöntemlerinin egzersiz uyumuna etkisi. JETR. 2025;12(3):154-6.