Behaviour change and rehabilitation adherence in adults with tendinopathy: a scoping review
Creators: name: Phillips, Rebecca
name: Hilton, Catherine
name: Filho, Luis Fernando Sousa
name: Farlie, Melanie
name: Morrissey, Dylan
name: Malliaras, Peter
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Space Science
subject: Medicine
subject: Sociology
subject: FOS: Sociology
subject: Biological Sciences not elsewhere classified
subject: Science Policy
subject: Mental Health

description: This scoping review aimed to identify behaviour change strategies influencing rehabilitation adherence in adults with tendinopathy, a common musculoskeletal condition requiring prolonged rehabilitation with poor adherence and variable outcomes. Following the Joanna Briggs Institute (JBI) methodology, seven databases were searched until April 2023. Records included reviews, intervention, and qualitative studies published in English. Behaviour change strategies were deductively coded and mapped to the capability, opportunity, and motivation model of behaviour (COM-B). Eighty-six articles were retained. The primary behaviour change strategies in tendinopathy rehabilitation reports addressed <i>Psychological Capability</i>; from knowledge through education, instruction, and self-monitoring using exercise diaries. Also, <i>Social Opportunity</i> involves demonstration and monitoring of rehabilitation behaviour, and <i>Physical Opportunity</i> focuses on time-efficient programs with access to equipment and health professionals. Few reports addressed <i>Automatic Motivatio</i>n (positive reinforcement and habit formation). Barriers identified in the reports were <i>Reflective Motivation</i> (negative beliefs and fears), <i>Physical Opportunity</i> (time-constraints), and <i>Physical Capability</i> (pain and comorbidities). Further research should explore the impact of education on beliefs, fears, and pain-management, as well as the effectiveness of teaching habit formation for improved time-management. Implementing these behaviour change strategies may enhance tendinopathy rehabilitation adherence, improving clinical trial efficacy, guiding clinical practice, and impacting patient outcomes. Education, instruction and use of an exercise diary (<i>Psychological Capability</i>), demonstration and monitoring of rehabilitation behaviour (<i>Social Opportunity</i>), and a time-efficient program with access to equipment and a health professional (<i>Physical Opportunity</i>) are common behaviour change strategies to improve rehabilitation adherence.A barrier to adherence we identified was negative beliefs about capabilities and consequences, and fear of pain and causing further damage (<i>Reflective Motivation</i>), which may be addressed by appropriate education.Positive reinforcement and teaching habit formation (<i>Automatic Motivation</i>) is not present in reports and should be considered in the future.<i>Physical Capability</i> of tendinopathy patients to perform the rehabilitation program should not be assumed by rehabilitation professionals when prescribing and delivering rehabilitation. Education, instruction and use of an exercise diary (<i>Psychological Capability</i>), demonstration and monitoring of rehabilitation behaviour (<i>Social Opportunity</i>), and a time-efficient program with access to equipment and a health professional (<i>Physical Opportunity</i>) are common behaviour change strategies to improve rehabilitation adherence. A barrier to adherence we identified was negative beliefs about capabilities and consequences, and fear of pain and causing further damage (<i>Reflective Motivation</i>), which may be addressed by appropriate education. Positive reinforcement and teaching habit formation (<i>Automatic Motivation</i>) is not present in reports and should be considered in the future. <i>Physical Capability</i> of tendinopathy patients to perform the rehabilitation program should not be assumed by rehabilitation professionals when prescribing and delivering rehabilitation.