December 2021

Adherence to remote physical therapy in people with neuromuscular disorders: identifying and addressing barriers and facilitators

Duration: Dec 2021 - Apr 2022

Neuromuscular disorder (NMD) include a range of conditions that impair the functioning of the muscles. NMD treatment aims at improving symptoms, increasing mobility and lengthen life. Regular and tailored physical therapy (PT) is an important element of treatment plans and adherence to it is crucial for treatment efficacy. As adherence is known to be difficult, patients can benefit from digital solution to support them but these must fit their needs.

The aim of this project is to identify barriers and facilitators of adherence to remote PT in people with NMD, in order to create a model that can be used in a digital solution. The development of this digital solution itself lies outside the scope of this proposal.

The study consists of two parts: 1) a literature study and 2) online focus groups. Based on the result a model for PT adherence in NMD will be built.

Literature review
The literature aims to provide an overview of existing evidence on adherence to (remote) PT exercise programs, and identify barriers and facilitators. We will search Medline (Pubmed) to retrieve studies. To achieve a broad description of the problem all types of studies will be included, including qualitative studies. An overview of barriers and facilitators of remote PT programs as well as theoretical models used will be made. Knowledge gaps arising from this literature search will be documented.

Focus groups
Online focus groups (6-8 participants each) will be set up in with patients and their caregivers to hear their perspective on remote PT and to fill potential knowledge gaps arising from part 1. In the focus groups we will further explore barriers and facilitators for adherence to remote PT and potential solutions that are appealing to patients.

Model building
The information from the focus groups, the literature search, and critical thinking of existing theories will be combined to summarize key determinants of adherence behaviour. Based on these results we will develop the model, while – as stated above - informing us by theories of behaviour and behaviour change.

Main Deliverables
• Theoretical framework containing barriers and facilitators for adherence to remote PT programs
• Scientific article on literature and focus groups results