{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T18:35:44Z","timestamp":1762281344508,"version":"build-2065373602"},"reference-count":27,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:00:00Z","timestamp":1760227200000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011698","name":"Chartered Society of Physiotherapy Charitable Trust","doi-asserted-by":"publisher","award":["RP\/19\/01"],"award-info":[{"award-number":["RP\/19\/01"]}],"id":[{"id":"10.13039\/100011698","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,11]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the longitudinal experience of taking part in a physiotherapy-led exercise adherence programme as part of the OsteoPorosis Tailored exercise adherence INtervention (OPTIN) trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Longitudinal qualitative study using semi-structured interviews analysed with reflexive thematic analysisan interpretive approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK National Health Service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>12 participants with vertebral fragility fracture (VFF) within the exercise adherence intervention arm of the OPTIN trial (n=63 in each arm). Interviews were undertaken with each participant at three time points: (1) within the first 2 weeks of initial assessment, (2) at the end of the 16-week intervention and (3) a year post-baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We distilled five themes. (1) One size does not fit all: this focuses on the importance of a physiotherapist individualising the exercise programme and how participants adapt it into their lives. (2) My mind and body can be in conflict or work together: this spotlights the strong link between ones emotional and mental state with their physical state, and how they can work to positively or negatively affect exercise adherence behaviour. (3) Expanding my circle of support: this revolves around the need for support systems beyond family and friends to the physiotherapist and other people with osteoporosis. (4) Transitioning from an exercise programme to a lifestyle change: this encompasses a longitudinal perspective of the exercise programme tapering, becoming intermittent or dropping off after a year, then being replaced by sustained lifestyle changes. (5) Moving from fear to empowerment: this explores the fear and loss of former identity after VFF diagnosis transforming into hope, confidence and empowerment through knowledge, advice and coping strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the need to work with mind and body to empower lifestyle changes and the importance of educating, tailoring, empathising and allying with the participantall critical areas clinicians can target when treating patients with VFFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trail registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"nct\" xlink:href=\"NCT14465704\">NCT14465704<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-096314","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:29:33Z","timestamp":1760621373000},"page":"e096314","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Using an outpatient physiotherapist-led behaviour change intervention to promote exercise adherence in people with vertebral fragility fracture: a longitudinal qualitative study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct14465704","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct14465704","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1422-4625","authenticated-orcid":false,"given":"Erin","family":"Hannink","sequence":"first","affiliation":[{"name":"Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Room","sequence":"additional","affiliation":[{"name":"Oxford Brookes University, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9363-0383","authenticated-orcid":false,"given":"Karen L","family":"Barker","sequence":"additional","affiliation":[{"name":"Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"},{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2025110323164171000_15.10.e096314.1","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s00198-022-06647-w","article-title":"A 3-year retrospective analysis of patients admitted with clinical vertebral fragility fractures across hospitals in England, UK","volume":"34","author":"Tan","year":"2023","journal-title":"Osteoporos Int"},{"key":"2025110323164171000_15.10.e096314.2","doi-asserted-by":"crossref","DOI":"10.1007\/s11657-020-0706-y","article-title":"Fragility fractures in Europe: burden, management and opportunities","volume":"15","author":"Borgstrm","year":"2020","journal-title":"Arch Osteoporos"},{"key":"2025110323164171000_15.10.e096314.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2017.10.001"},{"key":"2025110323164171000_15.10.e096314.4","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00198-020-05602-x","article-title":"Association between mortality risk and the number, location, and sequence of subsequent fractures in the elderly","volume":"32","author":"Lee","year":"2021","journal-title":"Osteoporos Int"},{"key":"2025110323164171000_15.10.e096314.5","unstructured":"National osteoporosis society. In: NOS Exercise and Osteoporosis Consensus Statement 2019. Available: https:\/\/www.bgs.org.uk\/resources\/strong-steady-straight-nos-exercise-and-osteoporosis-consensus-statement"},{"key":"2025110323164171000_15.10.e096314.6","unstructured":"National Osteoporosis Guideline Group. Clinical guideline for the prevention and treatment of osteoporosis, 2021. 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