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Adherence to Exercise Intervention Including Pain Threshold, Exercise and Physiotherapy Sessions for Patients With
Sebastian Åxman1, Rene Brüggebusch Svensson2, Camilla Cullum1
1Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen; Department of Orthopaedic Surgery, Institute of Sports Medicine, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen.
Patients with chronic rotator cuff tendinopathy adhered to prescribed pain thresholds during exercise. Adherence to physiotherapy and exercise was good, though logbook use decreased over the 26-week intervention.
Area of Science:
- Orthopedics
- Sports Medicine
- Physical Therapy
Background:
- Chronic rotator cuff tendinopathy significantly impacts shoulder function and quality of life.
- Exercise interventions are a cornerstone of management, but adherence to pain guidelines is crucial for efficacy and safety.
Purpose of the Study:
- To evaluate adherence to two distinct pain threshold protocols (pain allowed vs. pain avoided) in patients undergoing a 26-week exercise program for chronic rotator cuff tendinopathy.
- To assess adherence to exercise completion and physiotherapy sessions within these protocols.
Main Methods:
- Secondary data analysis from a randomized controlled trial (PASE trial) involving 84 patients with chronic rotator cuff tendinopathy.
- Participants were randomized to either exercising with pain up to 5 (PAllow) or below 3 (PAvoid) on the Numeric Pain Rating Scale.
- Adherence was measured by pain and exercise logbooks and attendance at physiotherapy sessions.
Main Results:
- Both groups successfully adhered to their assigned pain thresholds, with mean exercise pain levels significantly differing between groups (P < 0.001).
- Adherence to pain and exercise logbooks declined over the 26 weeks (from 76% to 68% and 75% to 61%, respectively), with no significant group difference.
- Physiotherapy attendance was high (75% attended ≥6 of 8 sessions), with no significant difference between groups.
Conclusions:
- Patients with chronic rotator cuff tendinopathy can adhere to prescribed pain thresholds during exercise interventions.
- Good adherence to exercise and physiotherapy was observed, but the use of self-monitoring tools like logbooks decreased over time, especially after the cessation of direct supervision.
