title: Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.
abstract: This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score < or =-2.5, predicted compliance (OR=0.34; 95% CI, 0.10 to 1.16). Despite the addition of an educational session to usual medical care to inform participants about the benefits of exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.
authors.affiliation: Rehabilitation Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, René Descartes University, F-75014 Paris Cedex, France. anne.mayoux-benhamou@cch.ap-hop-paris.fr
authors.forename: M A
authors.initials: MA
authors.lastname: Mayoux-Benhamou
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: A
authors.initials: A
authors.lastname: Perraud
authors.forename: J
authors.initials: J
authors.lastname: Fermanian
authors.forename: H
authors.initials: H
authors.lastname: Rahali-Kachlouf
authors.forename: M
authors.initials: M
authors.lastname: Revel
mesh_terms: D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control* / Q000523:psychology; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D013995:Time
references.citation: CMAJ. 1998 Nov 17;159(10 ):1253-7
references.pmid: 9861222
references.citation: Arthritis Rheum. 2004 Feb 15;51(1):63-72
references.pmid: 14872457
references.citation: Calcif Tissue Int. 2000 Feb;66(2):113-8
references.pmid: 10652958
references.citation: Calcif Tissue Int. 1993 Nov;53(5):307-11
references.pmid: 8287317
references.citation: Ann Intern Med. 1992 Jun 15;116(12 Pt 1):990-5
references.pmid: 1586110
references.citation: Res Nurs Health. 1997 Oct;20(5):377-87
references.pmid: 9334792
references.citation: BMJ. 2000 Feb 5;320(7231):341-6
references.pmid: 10657327
references.citation: Med Sci Sports Exerc. 1997 Aug;29(8):977-85
references.pmid: 9268953
references.citation: Obstet Gynecol. 2000 Apr;95(4):507-12
references.pmid: 10725481
references.citation: Calcif Tissue Int. 1989 May;44(5):312-21
references.pmid: 2496902
references.citation: Lancet. 2002 May 18;359(9319):1761-7
references.pmid: 12049882
references.citation: J Clin Epidemiol. 2001 Dec;54 Suppl 1:S57-60
references.pmid: 11750211
references.citation: J Bone Miner Res. 1996 Feb;11(2):218-25
references.pmid: 8822346
references.citation: Osteoporos Int. 2000;11(3):192-202
references.pmid: 10824234
references.citation: Med Care. 1992 Jun;30(6):473-83
references.pmid: 1593914
references.citation: Women Health. 1990;16(3-4):177-91
references.pmid: 2267806
references.citation: Calcif Tissue Int. 2002 Aug;71(2):112-20
references.pmid: 12200644
references.citation: Sports Med. 1992 Feb;13(2):78-85
references.pmid: 1561510
references.citation: Br J Obstet Gynaecol. 1992 Apr;99(4):325-8
references.pmid: 1581279
references.citation: J Womens Health. 1997 Aug;6(4):459-65
references.pmid: 9279834
references.citation: BMJ. 1999 Jan 23;318(7178):205-6
references.pmid: 9915707
references.citation: Calcif Tissue Int. 1997 Apr;60(4):348-53
references.pmid: 9075631
references.citation: Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1438-44
references.pmid: 2240084
references.citation: J Bone Miner Res. 1999 Dec;14(12):2143-9
references.pmid: 10620074
references.citation: Osteoporos Int. 1992 Mar;2(2):55-69
references.pmid: 1536981
references.citation: Lancet. 1996 Nov 16;348(9038):1343-7
references.pmid: 8918277
references.citation: Calcif Tissue Int. 1985 Jul;37(4):411-7
references.pmid: 3930039
references.citation: Menopause. 2001 Summer;8(2):141-8
references.pmid: 11256875
references.citation: BMJ. 2003 Apr 12;326(7393):793
references.pmid: 12689976
references.citation: BMJ. 1999 Sep 25;319(7213):828-32
references.pmid: 10496829
references.citation: J Bone Miner Res. 1995 Sep;10(9):1303-11
references.pmid: 7502701
references.citation: J Rheumatol. 1997 Mar;24(3):470-6
references.pmid: 9058651
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Feb;55(2):M74-83
references.pmid: 10737689
references.citation: Osteoporos Int. 1997;7(4):331-7
references.pmid: 9373566
references.citation: Prev Med. 1998 Jul-Aug;27(4):506-13
references.pmid: 9672943
references.citation: JAMA. 1995 Feb 1;273(5):402-7
references.pmid: 7823386
references.citation: J Clin Epidemiol. 1995 Aug;48(8):1051-60
references.pmid: 7775992
references.citation: Maturitas. 1992 Oct;15(2):151-8
references.pmid: 1470047
references.citation: J Bone Miner Res. 2003 Jul;18(7):1254-60
references.pmid: 12854835
references.citation: Osteoporos Int. 1993 Jan;3(1):13-7
references.pmid: 8422510
references.citation: Osteoporos Int. 2003 Aug;14(8):677-82
references.pmid: 12879220
references.citation: J Bone Miner Res. 1990 Aug;5(8):843-50
references.pmid: 2239368
references.citation: Spine (Phila Pa 1976). 1999 Oct 15;24(20):2162-70
references.pmid: 10543016
references.citation: Calcif Tissue Int. 1994 Apr;54(4):249-55
references.pmid: 8062139