Exercise adherence

Research strategy for “Technology to measure and improve exercise-therapy adherence – Copenhagen (TECHX-CPH)”




To investigate how various technologies can measure and improve adherence to home-based exercise in different patient populations, who are commonly prescribed home-based exercise after initial instructions.    

The experimental approach is a 3-phased model with initial phase-1 validation work in healthy subjects. The main findings from this phase have been: development and validation of gold-standard sensor technology to measure adherence and quality of home-based, elastic band exercise (Rathleff et al 2014; Rathleff et al 2013; Rathleff et al 2015), and validation of second generation, commercially available, sensor technology (McGirr et al 2015; Faber et al 2015). Some phase-1 validation work is still ongoing.

Currently, the strategy has a strong focus on feasibility assessment in different patient populations, that is, does the technology actually work as intended when used in a clinical setting (see for example, Rathleff et al 2016). This second phase is a pre-requisite for the following third phase of large-scale randomized controlled trials, using the technology to objectively quantify and improve adherence to home-based exercise in different patient populations, who are commonly prescribed home-based exercise after initial instructions.

TECHX-CPH Collaborators
The basis for the research strategy is a strong collaboration between PMR-C and the Research Unit for General Practice in Aalborg, Aalborg University, Denmark (Dr. Michael Rathleff). In addition, the strategy involves ongoing collaboration with other frontline research groups and programs, including: The Mærsk Mc-Kinney Møller Institute, University of Southern Denmark, Odense, Denmark, The Lundbeck Foundation Centre for Fast-Track Hip and Knee Replacements, Copenhagen, Denmark, Clinical Orthopedic Research Hvidovre, Copenhagen (CORH), Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen, Research Unit, Center for Elective Surgery, Silkeborg, Denmark, and the municipalities Hvidovre, Brøndby, and Copenhagen.  

Selected papers published under TECHX-CPH
Rathleff MS, Bandholm T, McGirr KA, Harring S, Sørensen AS, Thorborg K (2016). New exercise-integrated technology can monitor the dosage and quality of exercise performed against an elastic resistance band by adolescents with patellofemoral
pain: an observational study. J Physiother (Epub aheaf of print).  

Riel H, Matthews M, Vicenzino B, Bandholm T, Thorborg K, Rathleff MS (2016). Efficacy of live feedback to improve objectively monitored compliance to prescribed, home-based, exercise therapy-dosage in 15 to 19 year old adolescents with patellofemoral pain . a study protocol of a randomized controlled superiority trial (The XRCISE-AS-INSTRUcted-1 trial). BMC Musculoskeletal Disord 17: 242. 

Faber MMF, Andersen MH, Sevel C, Thorborg K, Bandholm T, Rathleff M (2015). The majority are not performing home-exercises correctly two weeks after their initial instruction: an assessor-blinded study. PeerJ 3:e1102. 

McGirr K, Harring SI, Kennedy TSR, Pedersen MFS, Hirata RP, Thorborg K, Bandholm T, Rathleff MS (2015). An elastic exercise band mounted with a Bandcizer can differentiate between commonly prescribed home exercises for the shoulder. Int J Sports Phys Ther 10: 1-9.  

Rathleff MS, Thorborg K, Rode LA, McGirr K, Sørensen AS, Bøgild A, Bandholm T (2015). Adherence to commonly prescribed, home-based strength training exercises for the lower extremity can be objectively monitored using the Bandcizer. J Strength Cond Res 29: 627-636. 

Rathleff MS, Bandholm T, Ahrendt P, Olesen JL, Thorborg K (2014). Novel stretch-sensor technology allows quantification of adherence and quality of home-exercises: a validation study. Br J Sports Med 48: 724-728.

Rathleff MS, Thorborg K, Bandholm T (2013). Concentric and eccentric time-under-tension during strengthening exercises: validity and reliability of stretch-sensor recordings from an elastic exercise-band. PLoS One 8: e68172.

Examples of ongoing research under TECHX-CPH

  • Live feedback to increase exercise adherence in adolescents with patellofemoral pain, The XRCISE-AS-INSTRUcted-1 trial, trial registration: NCT02674841, link to protocol paper here.
  • Quadriceps exercise before total knee arthroplasty (The QUADX-1 trial), trial registration: NCT02931058
  • Pragmatic home-based exercise after total hip arthroplasty – Silkeborg 1, (The PHETAS-1 trial), pending trial registration
  • Patients with subacromial pain, The SEXsI-trial, trial registration: NCT02747251



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