Predictors of adherence to prescribed exercise programs for older adults with medical or surgical indications for exercise: a systematic review

Table 4 Grading of recommendation assessment, development, and evaluation

Predictors	Participants	Studies	+	0	−	Phase	Limitations	Inconsistency	Indirectness	Imprecision	Publication bias	↑ effect size	Dose effect	Quality	Effect
*Demographic*
Age (older)	3591	10	2	5	3	2	✓	X	✓	✓	✓	∅	∅	M	~
Sex (male)	2487	6		6		2	✓	✓	✓	✓	✓	∅	∅	H	~
Employed	936	3	1	1	1	2	✓	X	✓	✓	X	∅	∅	L	~
More education	1300	3	1	2		2	✓	X	✓	X	X	∅	∅	VL	~
Living alone	210	2		2		2	✓	X	✓	✓	X	∅	∅	L	~
Lower SES	842	2			2	2	✓	✓	✓	X	X	∅	∅	L	↓
*Psychological*
Anxiety	1727	4	1		3	2	✓	X	✓	✓	X	∅	∅	L	~
Depression	3775	7		2	5	2	✓	✓	✓	✓	✓	∅	Δ	H	↓
Higher self-efficacy	313	3	3			2	✓	✓	✓	X	X	∅	Δ	M	↑
Higher control	226	2		2		2	✓	✓	✓	X	X	∅	∅	L	~
Good mental health	884	2	2			2	✓	✓	✓	✓	X	∅	∅	M	↑
*Comorbidities*
High BMI	1848	3		3		2	✓	✓	✓	✓	X	∅	∅	M	~
Smoker	1446	5	1	2	2	2	✓	X	✓	✓	X	∅	∅	L	~
High cholesterol	158	3	1	2		2	✓	X	✓	X	X	∅	∅	VL	~
Hypertension	128	2		2		2	✓	✓	✓	X	X	∅	∅	L	~
Higher CCI	1268	2		2		2	✓	✓	✓	✓	X	∅	∅	M	~
*Condition severity*
Better respiratory function	878	2	1	1		2	✓	X	✓	✓	X	∅	∅	L	~
Higher FEV1	1658	2	1	1		2	✓	X	✓	✓	X	∅	∅	L	~
*Program*
Farther distance	1444	2			2	2	✓	✓	✓	✓	X	∅	∅	M	↓
Continuous exercise (vs intermittent)	75	2^a	1		1	2	✓	X	✓	✓	X	∅	∅	M	~
*Other*
Exercise history	160	2	1	1		2	✓	X	✓	X	X	∅	∅	VL	~

+ = number of studies with a significant positive effect; 0 = number of studies with no significant effect; − = number of studies with a significant negative effect; ✓ = no serious limitations; ^arandomized controlled trials; X serious limitations, Δ= present, ∅ not present, M moderate, H high, L low, VL very low

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