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European Journal of Physical and Rehabilitation Medicine 2017 August;53(4):590-602

DOI: 10.23736/S1973-9087.17.04482-3


language: English

Motives for physical exercise participation as a basis for the development of patient-oriented exercise interventions in osteoarthritis: a cross-sectional study

Inga KRAUSS 1 , Uwe KATZMAREK 1, Monika A. RIEGER 2, 3, Gorden SUDECK 4

1 Department of Sports Medicine, Medical Clinic, University Hospital of Tübingen, Tübingen, Germany; 2 Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Tübingen, Germany; 3 Coordination Center, Core Facility for Health Services Research, Faculty of Medicine, Eberhard Karls University of Tübingen, Tübingen, Germany; 4 Institute of Sports Science, University of Tübingen, Tübingen, Germany


BACKGROUND: Physical exercises are effective in the treatment of osteoarthritis (OA). There is consensus that exercise interventions should take into account the patient’s preferences and needs in order to improve compliance to exercise regimes. One important personal factor is the patient’s motivation for physical exercise. Health improvement is a relevant motive for exercise participation. Accordingly, exercise interventions primarily focus on health related needs such as strengthening and pain reduction. However exercising provides further many-faceted incentives that may foster exercise adherence.
AIM: The present study aimed to characterize target groups for person-tailored exercise interventions in OA according to the International Classification of Functioning and Disability and Health (ICF). Target groups should be classified by similar individual exercise participation motive profiles and further described by their disease-related symptoms, limitations and psychological determinants of exercise behavior.
DESIGN: Observational study via self-administered questionnaires.
SETTING: Community.
POPULATION: We enrolled 292 adults with hip/knee OA living independently of assistance.
METHODS: Participants completed the Bernese Motive and Goal Inventory in Leisure and Health Sports (BMZI), the Hannover Functional Ability Questionnaire for Osteoarthritis, the WOMAC-Index (pain/stiffness), the General Self-efficacy Scale and a questionnaire on perceived barriers to exercise participation. The BMZI-scales served as active variables for cluster analysis (Ward’s method), other scales were used as passive variables to further describe the identified clusters.
RESULTS: Four clusters were defined using five exercise participation motives: health, body/appearance, esthetics, nature, and contact. Based on the identified motive profiles the target groups are labelled health-focused sports people; sporty, nature-oriented individualists; functionalists primarily motivated by maintaining or improving health through exercise; and nature-oriented, health-conscious exercisers.
CONCLUSIONS: This study contributes to the development of person-oriented exercise recommendations with a special regard to motives for exercise participation. This study delineates four phenotypes with distinctive profiles of facilitators and barriers to exercise behavior. Key aspects of person-oriented exercise interventions could be defined according to each phenotype.
CLINICAL REHABILITATION IMPACT: Incentives related to physical exercise such as enjoyment, contact, or natural environment may encourage compliance to an exercise intervention. Goal setting in the context of OA rehabilitation should therefore not only refer to health-oriented reasons but also reconsider individual motives for exercise participation.

KEY WORDS: Osteoarthritis - Exercise - International Classification of Functioning, Disability and Health

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