Interventions to achieve ongoing exercise adherence for adults with chronic health conditions who have completed a supervised exercise program: Systematic review and meta-analysis

Objective: To determine which exercise adherence interventions are most effective for achieving ongoing exercise adherence in adults with chronic health conditions who had already completed a supervised short-term program. Method: Search of MEDLINE (Ovid Medline 1946 to April 8^th, 2016), EMBASE (1980 to April 8^th, 2016), CINAHL (1982-April 8^th 2016) and the Cochrane Central Register of Controlled Trials was conducted. The chronic health conditions search terms as per the Chronic Disease and Participation in Work AIHW Report, 2008. Included were randomised (or quasi-randomised) trials and observational studies evaluating interventions that aimed to improve exercise adherence in adults with chronic health conditions that had completed a supervised exercise program. Random-effects meta-analyses and random-effects logistic meta-regression were used to examine relationships between exercise adherence strategy and adherence. Results: Eleven studies were included with a total of 1231 participants with Chronic Obstructive Pulmonary Disease, Diabetes, Cardiovascular disease or Osteoarthritis. Methods used for maintaining adherence were categorized post hoc as: centre based programs; home exercise programs with telephone follow-up; home exercise programs with no follow-up; and weaning programs that transitioned patients to an independent, off-site exercise program. There was no difference in the proportion of participants who were fully adherent to an exercise program 12 months between the centre-based follow-up (pooled proportion fully adherent=0.34) and telephone follow-up (pooled proportion fully adherent=0.30, difference p-value=0.75). Conclusion: Interventions such as centre-based exercise programs or home exercise programs (with or without telephone follow-up) do not differentially impact exercise adherence for people who have completed a short-term supervised program.