Predictors of Exercise Adherence in Patients With Meniscal Tear and Osteoarthritis

Objective: To identify predictors of poor exercise adherence in patients with osteoarthritis (OA) and meniscal tear. Design: Secondary analysis of data gathered over the first 12 weeks in the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial, a multicenter, randomized controlled trial. Setting: Seven referral centers. Participants: Most of the patients in the MeTeOR trial (N=325 of 351) were included in the analysis, each of whom was aged >= 45 years and had a meniscal tear and osteoarthritic changes on imaging studies; 26 were excluded because of missing data from which to derive the primary outcome variable. Interventions: All patients received a structured, supervised exercise program focused on strengthening, along with prescribed home exercises; half were randomly assigned to also receive arthroscopic partial meniscectomy. Main Outcome Measure: Poor exercise adherence through 12 weeks, defined as performing <50% of prescribed exercise. Results: Thirty-eight percent of the MeTeOR cohort showed poor exercise adherence. In the multivariate model, adjusting for treatment group, those who earned <=$29,000 per year had 1.64 times the risk of nonadherence (95% confidence interval [CI], 1.10-2.43) than those who earned >$100,000 per year; and those without baseline pain with pivoting and twisting had 1.60 times greater risk of nonadherence than those with these symptoms (95% CI, 1.14-2.25). Conclusions: Low income was associated with poor exercise adherence among patients aged >= 45 years with OA and a meniscal tear, as was absence of pain with pivoting and twisting. Our findings highlight the need for further research into exercise adherence and for interventions to enhance adherence among those with low incomes. (C) 2016 by the American Congress of Rehabilitation Medicine