McCreesh K1,2, O'Connor C1, McNamara J1, Fahy K1, Cleary N1, Deering P1
1University of Limerick, School of Allied Health, Limerick, Ireland, 2Health Research Institute, University of Limerick, Limerick, Ireland

Background: Exercise is one of the most effective interventions for shoulder pain. The limited methods available to accurately measure adherence to home exercise constitute a major challenge for clinicians. The BandCizer™ is a novel device that attaches to a resistance band and objectively measures adherence using stretch-sensor technology. It has been shown to be a valid and reliable tool for measuring exercise quality (i.e. time under-tension (TUT)) and quantity (i.e. number of repetitions). As this device has not yet been investigated within a clinical shoulder pain population, this study aimed to evaluate feasibility of the Bandcizer device in measuring adherence to a home exercise programme in adults with shoulder pain.
Method: Adults (≥18 years old) with shoulder pain (≥6 weeks), not currently.

Purpose: The primary objective of the current study was to evaluate the adherence levels of adults with shoulder pain to a prescribed home exercise programme, in terms of number of repetitions and TUT, using the BandCizer device. Secondary outcome measures also allowed evaluation of the impact of adherence on pain and disability. Finally, using daily exercise diaries to note repetitions completed , further comparisons were made between objective and self-reported adherence levels.

Methods: Adults (≥18 years old) with shoulder pain (≥6 weeks) with no neurological/rheumatologic disorders, were eligible. The intervention involved a 6-week daily exercise programme involving 2-3 exercises, 2-3 sets of 10 repetitions, with a TUT of 80s per set. The Bandcizer device recorded adherence for the initial 2-weeks. The Numerical Rating Scale (NRS) and Shoulder Pain and Disability Index (SPADI) were completed at baseline and 6 weeks with the minimal detectable change (MDC) set at 2.5 and 18 points respectively. Participants recorded their pain using the NRS before and after daily sessions and documented adherence using self-completed exercise diaries.

Results: Eleven participant data sets were available for analysis. There was an average 52% adherence to the prescribed exercise dose, and TUT. Adherence to number of repetitions was higher (76%), comparable to self-reported levels of 79%. Five participants exceeded the MDC threshold for the SPADI, and three for the NRS. On average, participants completed 8 repetitions/set with a TUT of 40s/set (range 21-60s).

Conclusion(s): The BandCizer™ device was effective in objectively quantifying adherence to TUT and repetitions completed. Despite less than optimal adherence, the intervention still produced significant changes in pain and disability. Adherence within this study was considerably higher compared to similar studies with adolescent participants. Unlike previous studies showing over-reporting of adherence, self-reported adherence in this study was similar to objective findings.These findings support the need for further research into the importance of adherence to home exercise prescription, and to help identify which parameters of exercise dosage are most important in enhancing treatment efficacy within this population.

Implications: This study supports the feasibility of the Bandcizer device for monitoring quality and quantity of home exercise for shoulder pain. Given that that participants adhered considerably more closely to the number of repetitions than the time under tension prescribed, therapist may need to pay more attention to this aspect of the exercise prescription.

Keywords: shoulder pain, exercise, adherence

Funding acknowledgements: Health Research Board of Ireland Summer studentship.
Procare Denmark provided the BandCizer™ devices.

Topic: Musculoskeletal: upper limb

Ethics approval required: Yes
Institution: University of Limerick, Limerick, Ireland
Ethics committee: Faculty of Education and Health Sciences
Ethics number: 2016_06_24_EHS

All authors, affiliations and abstracts have been published as submitted.

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