PhD confirmation seminar - Adherence to exercise in people with knee osteoarthritis


Philippa Nicolson, PhD Candidate, CHESM, Department of Physiotherapy


Prof Rana Hinman, Prof Kim Bennell


Exercise is recommended by all clinical guidelines for people with knee osteoarthritis (OA), irrespective of disease severity, pain levels and functional status. Substantial research evidence now supports the use of prescribed home exercise in the management of knee osteoarthritis. However, multiple studies have shown that the benefits of exercise decline rapidly over time. Poor adherence to prescribed exercise programs has been identified as an important factor limiting longer-term effectiveness. Adherence to exercise is a complex and multidimensional problem and as a result, it is both difficult to measure and difficult to improve. In order to actualize the true benefits of exercise for people with knee osteoarthritis achieving and maintaining adherence long term is essential.

This thesis aims to develop a greater understanding than currently exists of a number of aspects of adherence to exercise. Specifically this thesis will:

  • Examine the relationship between self-reported adherence to exercise and outcomes of pain, function and strength among a large cohort of people with knee OA.
  • Explore the validity and reliability of self-reported measures of adherence when compared to accelerometer measured adherence.
  • Evaluate interventions specifically aimed at increasing adherence to exercise that have been tested in randomised controlled trials and exploring which behaviour change techniques are preferred by physiotherapists and people with knee OA.

The knowledge gained from this thesis will lay the optimal foundation for the evaluation of evidence based interventions to improve adherence to exercise in a randomised controlled trial.


Thursday 21st April




G21 (Theatre 1)


Alan Gilbert