{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T17:18:12Z","timestamp":1769879892524,"version":"3.49.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004871","name":"Technische Universit\u00e4t Braunschweig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004871","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adherence and motivation are key factors for successful treatment of patients with chronic diseases, especially in long-term care processes like rehabilitation. However, only a few patients achieve good treatment adherence. The causes are manifold. Adherence-influencing factors vary depending on indications, therapies, and individuals. Positive and negative effects are rarely confirmed or even contradictory. An ontology seems to be convenient to represent existing knowledge in this domain and to make it available for information retrieval.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>First, a manual data extraction of current knowledge in the domain of treatment adherence in rehabilitation was conducted. Data was retrieved from various sources, including basic literature, scientific publications, and health behavior models. Second, all adherence and motivation factors identified were formalized according to the ontology development methodology METHONTOLOGY. This comprises the specification, conceptualization, formalization, and implementation of the ontology \u201c<jats:bold>On<\/jats:bold>tology for factors influencing <jats:bold>t<\/jats:bold>herapy <jats:bold>a<\/jats:bold>dherence to <jats:bold>r<\/jats:bold>ehab<jats:bold>i<\/jats:bold>litation\u201d (OnTARi) in Prot\u00e9g\u00e9. A taxonomy-oriented evaluation was conducted by two domain experts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>OnTARi includes 281 classes implemented in ontology web language, ten object properties, 22 data properties, 1440 logical axioms, 244 individuals, and 1023 annotations. Six higher-level classes are differentiated: (1) <jats:italic>Adherence<\/jats:italic>, (2) <jats:italic>AdherenceFactors<\/jats:italic>, (3) <jats:italic>AdherenceFactorCategory<\/jats:italic>, (4) <jats:italic>Rehabilitation<\/jats:italic>, (5) <jats:italic>RehabilitationForm<\/jats:italic>, and (6) <jats:italic>RehabilitationType<\/jats:italic>. By means of the class <jats:italic>AdherenceFactors<\/jats:italic> 227 adherence factors, thereof 49 hard factors, are represented. Each factor involves a proper description, synonyms, possibly existing acronyms, and a German translation. OnTARi illustrates links between adherence factors through 160 influences-relations. Description logic queries implemented in Prot\u00e9g\u00e9 allow multiple targeted requests, e.g., for the extraction of adherence factors in a specific rehabilitation area.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>With OnTARi, a generic reference model was built to represent potential adherence and motivation factors and their interrelations in rehabilitation of patients with chronic diseases. In terms of information retrieval, this formalization can serve as a basis for implementation and adaptation of conventional rehabilitative measures, taking into account (patient-specific) adherence factors. OnTARi also enables the development of medical assistance systems to increase motivation and adherence in rehabilitation processes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-021-01512-y","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T07:03:22Z","timestamp":1620716602000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["OnTARi: an ontology for factors influencing therapy adherence to rehabilitation"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6762-8973","authenticated-orcid":false,"given":"Bianca","family":"Steiner","sequence":"first","affiliation":[]},{"given":"Birgit","family":"Saalfeld","sequence":"additional","affiliation":[]},{"given":"Lena","family":"Elgert","sequence":"additional","affiliation":[]},{"given":"Reinhold","family":"Haux","sequence":"additional","affiliation":[]},{"given":"Klaus-Hendrik","family":"Wolf","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"1512_CR1","unstructured":"Sj\u00f6lund BH. Rehabilitation. In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. New York: Springer; 2003."},{"key":"1512_CR2","unstructured":"Bundesarbeitsgemeinschaft f\u00fcr Rehabilitation (BAR). Rahmenempfehlungen zur ambu-lanten Rehabilitation bei muskuloskeletalen Erkrankungen. Frankfurt am Main: BAR. 2005. https:\/\/www.bar-frankfurt.de\/fileadmin\/dateiliste\/_publikationen\/reha_vereinbarungen\/pdfs\/RahmenempfehluRa_muskuloskeletale_Erkrankung.pdf. Accessed 07 Nov 2020. GERMAN"},{"key":"1512_CR3","doi-asserted-by":"crossref","unstructured":"Greitemann B, Stein V. Praxis der konservativen Orthop\u00e4die \u2013 Rehabilitation in der Orthop\u00e4die. Orthop\u00e4die und Unfallchirurgie. 2013;8:503\u2013522. GERMAN","DOI":"10.1055\/s-0033-1346912"},{"key":"1512_CR4","unstructured":"Chaitow L. Naturopathic Physical Medicine: Theory and Practice for Manual Therapists and Naturopaths. Edinburgh: Elsevier Health Sciences; 2008."},{"key":"1512_CR5","unstructured":"Bundesarbeitergemeinschaft f\u00fcr Rehabilitation (BAR), editors. Praxisleitfaden: Strategien zur Sicherung der Nachhaltigkeit von Leistungen zur medizinischen Rehabilitation. Frankfurt\/Main: BAR; 2016. GERMAN"},{"key":"1512_CR6","unstructured":"World Health Organization. Adherence to Long-Term Therapies: Evidence for Action. Sabat\u00e9 E, editor. Genf: World Health Organization; 2003."},{"key":"1512_CR7","doi-asserted-by":"crossref","unstructured":"Koch U, Bengel J. Enzyklop\u00e4die der Psychologie. Anwendungen der Medizinischen Psychologie. G\u00f6ttingen: Hogrefe Verlag; 2017. Chapter 6, Therapieadh\u00e4renz; p. 527\u2013529.","DOI":"10.1026\/00578-000"},{"issue":"1","key":"1512_CR8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/2049-3258-72-37","volume":"72","author":"T Mathes","year":"2014","unstructured":"Mathes T, Jaschinski T, Pieper D. Adherence influencing factors \u2013 a systematic review of systematic reviews. Arch Public Health. 2014;72(1):37.","journal-title":"Arch Public Health"},{"issue":"6","key":"1512_CR9","doi-asserted-by":"publisher","first-page":"519","DOI":"10.3109\/09638288.2016.1153160","volume":"39","author":"R Essery","year":"2017","unstructured":"Essery R, Geraghty AWA, Kirby S, Yardley L. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil. 2017;39(6):519\u201334.","journal-title":"Disabil Rehabil"},{"issue":"1","key":"1512_CR10","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12911-019-0809-9","volume":"19","author":"K Livitckaia","year":"2019","unstructured":"Livitckaia K, Koutkias V, Kouidi E, van Gils M, Maglaveras N, Chouvarda I. \u201cOPTI-mAL\u201d: an ontology for patient adherence modeling in phyiscal activity domain. BMC Med Inform Decis Mak. 2019;19(1):92.","journal-title":"BMC Med Inform Decis Mak"},{"issue":"4","key":"1512_CR11","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/j.jbi.2013.04.009","volume":"46","author":"K Button","year":"2013","unstructured":"Button K, van Deursen RW, Soldatova L, Spasi\u0107 I. TRAK ontology: defining standard care for the rehabilitation of knee conditions. J Biomed Inform. 2013;46(4):615\u201325.","journal-title":"J Biomed Inform"},{"issue":"1","key":"1512_CR12","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s13326-016-0104-y","volume":"7","author":"I Berges","year":"2016","unstructured":"Berges I, Ant\u00f3n D, Berm\u00fadez J, Goni A, Illarramendi A. TrhOnt: building an ontology to assist rehabilitation processes. J Biomed Semantics. 2016;7(1):60.","journal-title":"J Biomed Semantics"},{"key":"1512_CR13","doi-asserted-by":"crossref","unstructured":"Lippke S, Renneberg B. Theorien und Modelle des Gesundheitsverhaltens. In: Renne-berg B, Hammelstein P, editors. Gesundheitspsychologie. Berlin, Heidelberg: Springer; 2006. p. 35\u201360. GERMAN","DOI":"10.1007\/978-3-540-47632-0_5"},{"key":"1512_CR14","unstructured":"Reuter T, Schwarzer R. Verhalten und Gesundheit. In: Bengel J, Jerusalem M, editors. Handbuch der Gesundheitspsychologie und Medizinischen Psychologie. G\u00f6ttingen: Hogrefe Verlag GmbH & Co. KG; 2009. p. 34\u201345. GERMAN"},{"key":"1512_CR15","doi-asserted-by":"crossref","unstructured":"Corcho O, Fern\u00e1ndez-L\u00f3pez M, G\u00f3mez-P\u00e9rez A, L\u00f3pez-Cima A. Building Legal On-tologies with METHONTOLOGY and WebODE. In: Benjamins VR, Casanovas P, Breuker J, Gangemi A, editors. Law and the Semantic Web. Legal Ontologies, Method-ologies, Legal Information Retrieval, and Applications. Berlin, Heidelberg: Springer; 2005. p. 142\u2013157.","DOI":"10.1007\/978-3-540-32253-5_9"},{"key":"1512_CR16","doi-asserted-by":"publisher","first-page":"220703","DOI":"10.1109\/ACCESS.2020.3041659","volume":"8","author":"L Zhu","year":"2020","unstructured":"Zhu L, Hua G. Theoretical perspective of multi-dividing ontology learning trick in two-sample setting. IEEE Access. 2020;8:220703\u20139.","journal-title":"IEEE Access"},{"issue":"1","key":"1512_CR17","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13677-020-00173-y","volume":"9","author":"W Gao","year":"2020","unstructured":"Gao W, Chen Y. Approximation analysis of ontology learning algorithm in linear combination setting. J Cloud Comp. 2020;9(1):29.","journal-title":"J Cloud Comp"},{"key":"1512_CR18","unstructured":"N\u00fcbling R, Kriz D, Herwig J, Wirtz M, Fuchs S, Hafen K et al. Patientenfragebogen zur Erfassung der Reha-Motivation (PAREMO-20): Kurzmanual. Freiburg: Albert-Ludwigs-Universit\u00e4t Freiburg. 2020. http:\/\/portal.uni-freiburg.de\/psychologie\/abteilungen\/Rehabilitationspsychologie\/downloads\/assessmentverfahren\/ . Accessed 06 Nov 2020. GERMAN"},{"key":"1512_CR19","unstructured":"WHO. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference. New York: World Health Organization. 1946. http:\/\/www.who.int\/suggestions\/faq\/en\/. Accessed 06 Nov 2020."},{"key":"1512_CR20","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1146\/annurev.clinpsy.121208.131339","volume":"6","author":"TL Patterson","year":"2010","unstructured":"Patterson TL, Mausbach BT. Measurement of functional capacity: a new approach to understanding functional differences and real-world behavioral adaptation in those with mental illness. Annu Rev Clin Psychol. 2010;6:139\u201354.","journal-title":"Annu Rev Clin Psychol"},{"key":"1512_CR21","unstructured":"Steinmann H, Schrey\u00f6gg G. Management. Grundlagen der Unternehmensf\u00fchrung. Konzepte \u2013 Funktionen \u2013 Fallstudien. Wiesbaden: Gabler; 2005. GERMAN"},{"key":"1512_CR22","unstructured":"Schubert FZ, Knecht A. Ressourcen - Merkmale, Theorien und Konzeptionen im \u00dcber-blick: eine \u00dcbersicht \u00fcber Ressourcenans\u00e4tze in Soziologie, Psychologie und Sozialpoli-tik. Mannheim: GESIS - Leibniz-Institut f\u00fcr Sozialwissenschaften; 2015. Chapter 2, Ressourcentaxonomie. p. 7\u201310. GERMAN"},{"key":"1512_CR23","unstructured":"Fahad M, Qadir MA. A Framework for Ontology Evaluation. In: Eklund PW, Haemmerl\u00e9 O, editors. Supplementary Proceedings of the 16th International Conference on Conceptual Structures. Berlin, Heidelberg: Springer; 2008."},{"key":"1512_CR24","doi-asserted-by":"crossref","unstructured":"Musen MA. The Prot\u00e9g\u00e9 project: A look back and a look forward. AI Matters. ACM SIGAI. 2015;1(4).","DOI":"10.1145\/2757001.2757003"},{"key":"1512_CR25","unstructured":"Zinn S. Patient Adherence in Rehabilitation. In: Bosworth HB, Oddone EZ, Weinberger M, editors. Patient Treatment Adherence. Concepts, Interventions, and Measurement. New Jersey: Lawrence Erlbaum Associates, Inc. 2006. p. 195\u2013238."},{"issue":"8","key":"1512_CR26","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1089\/jwh.2016.6249","volume":"26","author":"DM Resurrecci\u00f3n","year":"2017","unstructured":"Resurrecci\u00f3n DM, Motrico E, Rigabert A, Rubio-Valera M, Conejo-Cer\u00f3n S, Pastor L, et al. Barriers for nonparticipation and dropout of women in cardiac rehabilitation pro-grams: a systematic review. J Womens Health (Larchmt). 2017;26(8):849\u201359.","journal-title":"J Womens Health (Larchmt)"},{"key":"1512_CR27","doi-asserted-by":"crossref","unstructured":"Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, van't Hof A, Meindersma E et al. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol. 2016;223:436\u2013443.","DOI":"10.1016\/j.ijcard.2016.08.120"},{"issue":"1","key":"1512_CR28","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/j.0889-7204.2002.00614.x","volume":"17","author":"J Daly","year":"2002","unstructured":"Daly J, Sindone AP, Thompson DR, Hancock K, Chang E, Davidson P. Barriers to par-ticipation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs. 2002;17(1):8\u201317.","journal-title":"Prog Cardiovasc Nurs"},{"issue":"5","key":"1512_CR29","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1097\/HJR.0b013e3283299585","volume":"16","author":"M Petter","year":"2009","unstructured":"Petter M, Blanchard C, Kemp KAR, Mazoff AS, Ferrier SN. Correlates of exercise among coronary heart disease patients: review, implications and future directions. Eur J Cardiovasc Prev Rehabil. 2009;16(5):515\u201326.","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"1512_CR30","doi-asserted-by":"crossref","unstructured":"Resurrecci\u00f3n DM, Moreno-Peral P, G\u00f3mez-Herranz M, Rubio-Valera M, Pastor L, Cal-das de Almeida JM et al. Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies. Eur J Cardiovasc Nurs. 2019;18(1):38\u201347","DOI":"10.1177\/1474515118783157"},{"issue":"3","key":"1512_CR31","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/JCN.0b013e3181ef6b04","volume":"26","author":"GH Taylor","year":"2011","unstructured":"Taylor GH, Wilson SL, Sharp J. Medical, psychological, and sociodemographic factors associated with adherence to cardiac rehabilitation programs: a systematic review. J Cardiovasc Nurs. 2011;26(3):202\u20139.","journal-title":"J Cardiovasc Nurs"},{"issue":"1","key":"1512_CR32","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s11065-013-9227-4","volume":"23","author":"J Choi","year":"2013","unstructured":"Choi J, Twamley EW. Cognitive rehabilitation therapies for Alzheimer\u2019s disease: a re-view of methods to improve treatment engagement and self-efficacy. Neuropsychol Rev. 2013;23(1):48\u201362.","journal-title":"Neuropsychol Rev"},{"issue":"9","key":"1512_CR33","doi-asserted-by":"publisher","first-page":"1698","DOI":"10.1016\/j.apmr.2015.03.017","volume":"96","author":"J Luker","year":"2015","unstructured":"Luker J, Lynch E, Bernhardsson S, Bennett L, Bernhardt J. Stroke survivors\u2019 experiences of physical rehabilitation: a systematic review of qualitative studies. Arch Phys Med Rehabil. 2015;96(9):1698\u2013708.","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"1512_CR34","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1002\/pon.4612","volume":"27","author":"HL Ormel","year":"2018","unstructured":"Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psychooncology. 2018;27(3):713\u201324.","journal-title":"Psychooncology"},{"issue":"2","key":"1512_CR35","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1097\/AJP.0000000000000235","volume":"32","author":"EL Thompson","year":"2016","unstructured":"Thompson EL, Broadbent J, Bertino MD, Staiger PK. Do pain-related beliefs influence adherence to multidisciplinary rehabilitation?:A systematic review. Clin J Pain. 2016;32(2):164\u201378.","journal-title":"Clin J Pain"},{"issue":"8","key":"1512_CR36","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.2522\/ptj.20090245","volume":"90","author":"AM Hall","year":"2010","unstructured":"Hall AM, Ferreira PH, Maher CG, Latimer J, Ferreira ML. The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic re-view. Phys Ther. 2010;90(8):1099\u2013110.","journal-title":"Phys Ther"},{"key":"1512_CR37","doi-asserted-by":"crossref","unstructured":"Hoffmann S, Faselt F. Gesundheitspsychologie: Sozial-kognitive Ans\u00e4tze zur Erkl\u00e4rung des Gesundheitsverhaltens von Konsumenten. In: Hoffmann S, editors. Angewandtes Gesundheitsmarketing. Wiesbaden: Springer Fachmedien; 2012. p. 32\u201344. GERMAN","DOI":"10.1007\/978-3-8349-4035-3_3"},{"key":"1512_CR38","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s13326-018-0176-y","volume":"9","author":"S El-Sappagh","year":"2018","unstructured":"El-Sappagh S, Kwak D, Ali F, Kwak KS. DMTO: a realistic ontology for standard diabetes mellitus treatment. J Biomed Semant. 2018;9:8.","journal-title":"J Biomed Semant"},{"issue":"Suppl 10","key":"1512_CR39","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1186\/s12911-020-01336-2","volume":"20","author":"LT Slater","year":"2020","unstructured":"Slater LT, Gkoutos GV, Hoehndorf R. Towards semantic interoperability: finding and repairing hidden contradictions in biomedical ontologies. BMC Med Inform Decis Mak. 2020;20(Suppl 10):311.","journal-title":"BMC Med Inform Decis Mak"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-021-01512-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12911-021-01512-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-021-01512-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T07:05:09Z","timestamp":1620716709000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/s12911-021-01512-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,11]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1512"],"URL":"https:\/\/doi.org\/10.1186\/s12911-021-01512-y","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,11]]},"assertion":[{"value":"9 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"153"}}