Time limitations, physical environment, and previous negative experiences are the most common barriers for adherence to exercise therapy in children and adolescents with musculoskeletal conditions.
On the contrary, a social support network and previous positive exercise experiences are mostly mentioned as facilitators.
Although not usually included in either category, the most common strategies used to increase adherence were reinforcement, changes in the exercise programme, and education.
The wide range of barriers and facilitators present in the literature shows the need to engage in a discussion with patients, regardless of their age, to identify barriers and facilitators unique to each patient. However, a need remains for studies linking adherence, exercise therapy effectiveness, and health-related outcomes.
> From: Holt et al., J Orthop Sport Phys Ther 50 (2020) 503-515 (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.
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This review is an extremely useful resource for anyone dealing with children and teenagers with musculoskeletal conditions, as it not only identifies the most frequent barriers and facilitators of exercise adherence in a detailed manner, but also provides practical tips for implementing the findings in the clinical setting.
This is a great example of an intervention (increasing exercise adherence) that may have very little cost and bring huge benefits in the future by creating healthier citizens. Additionally, to be honest, we all know that strategies to make exercise fun and engaging can be applied even in 40- or 80-year old “teenagers”, so it is bound to have a wider scope of clinical use.
Best of all, the full text is free to access, so make sure you add it to your reading list!