Does exercise adherence influence outcome in knee osteoarthritis? – a secondary analysis of a superiority randomized controlled trial

BACKGROUND: = 189). OBJECTIVE: To examine associations between exercise adherence (number of treatments, exercises, repetitions, and exercise duration) and short-term clinical outcomes. METHODS: Adherence was measured by number of treatments, exercises, repetitions, and cycling duration expressed as a percentage of the prescribed dose. Pearson's correlations were calculated between adherence and outcomes: knee function (Knee Injury and Osteoarthritis Outcome Score - KOOS), eight pain visual analogue scales (VAS), and quality of life (EuroQol-5 Dimension - EQ5D). Student's t-tests assessed whether adherence was associated with achieving minimal clinically important difference (MCID). RESULTS: = .022). CONCLUSION: Despite lower adherence in the high-dose group, adherence showed little association with clinical outcomes. These results suggest that high adherence to high-dose exercise may not be necessary for short-term benefit, highlighting the need for further research on optimal dosage and identifying meaningful adherence components. TRIAL REGISTRATION: ClinicalTrials.gov NCT02024126. First version 2013-12-26.