What is a Home Exercise Program?
- promote recovery
- improve strength
- flexibility
- restore balance
- reduce pain
Ideally, an HEP is tailored to each patient’s needs with considerations of their diagnosis, limitations, and goals to empower patients to take an active role in their recovery, allowing them to continue rehabilitation outside of therapy sessions. An HEP is a vital component of physical therapy that empowers patients to actively participate in their recovery process, and it promotes continuity of care, allows for consistent engagement in therapeutic activities, and ultimately enhances the potential for positive outcomes in rehabilitation.
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Why Patient Adherence Matters
Patient adherence has become a highly prevalent topic in physical therapy, and for good reason. If you’re not familiar with patient adherence, it essentially refers to how well patients stick to their recommended HEPs in terms of frequency, duration, and intensity, and it directly affects how effective the physical therapy is for the patient.
Adherence to an HEP also prevents setbacks and re-injury, while helping to both maintain progress made during therapy sessions as well as minimize regression. It enhances stability, promotes healing, and prevents deconditioning, sustaining functional abilities and preventing relapses.
On top of that, adherence reflects a commitment to self-management and active participation in recovery. It empowers patients, fosters control, and promotes a proactive mindset.
Finally, patient adherence contributes to a positive therapeutic alliance by creating a partnership, enhancing communication, and building trust.
Factors Affecting Patient Adherence in Home Exercise Programs
Here are some key factors that can impact adherence in exercise programs:
Motivation and Beliefs
If you’re motivated, you’re more likely to stay committed, and this certainly applies to patients with their HEPs. But when patients feel doubts surrounding the effectiveness of an exercise, or even their own ability to do it, can get in the way of motivation. According to one editorial from The British Medical Journal, a patient’s perceptions, along with their habits, attitudes, and beliefs, can cause them to have misconceptions about their condition, and their preferences for certain interventions may be ineffective or even harmful. Overcoming this barrier and ensuring a successful intervention plan requires a strong relationship, trust, and effective communication between the physical therapist and the patient.
That’s why physical therapists need to tackle these beliefs head-on, teach patients about the benefits of exercise, and create a supportive environment that boosts their motivation.
Accessibility and Convenience
The accessibility and convenience of an HEP can greatly impact how likely a patient is to follow through on it. If the exercises require equipment they don’t have, or if they take up too much time, it can discourage patients from sticking to the program. That’s why physical therapists must consider a patient’s environment, resources, and schedule.
Physical and Emotional Barriers
Physical limitations like pain and fatigue, or emotional factors like stress, anxiety, or depression can greatly hinder patient adherence in an exercise program, as they may find it challenging to perform exercises consistently if they experience discomfort or are emotionally overwhelmed. Physical therapists should carefully assess and address these barriers, providing modifications, pain management strategies, or psychological support when necessary.
How to Create a Home Exercise Program that Can Improve Patient Adherence
01
Help Them Understand the Purpose
Educating patients about the purpose and goals of their HEP helps them grasp the relevance and importance of each exercise. Numerous studies from the Johns Hopkins University about patient adherence have consistently shown that patients’ comprehension of their medical conditions and treatment plans is directly linked to their adherence. Additionally, there is a positive correlation between adherence, patient satisfaction, recall, and the quantity and quality of information provided to patients.
When patients understand how specific exercises contribute to their recovery or functional improvement, they are more motivated to perform them consistently which, in turn, enhances patient engagement and compliance. That’s why Physiotec places a strong emphasis on providing knowledge through resources and literature for patient education.
02
Include Photos & Videos in Your Home Exercise Program
Visual cues in photos and videos can also help patients refine their technique and ensure they are performing exercises with the correct form. This is particularly crucial in physical therapy, as improper technique can lead to further injury or hinder progress. Patients can observe proper body alignment, joint positions, and movement patterns through visual media, enabling them to mimic the correct form and reduce the risk of injury.
03
Include Brief Descriptions of Each Exercise
Providing clear and concise descriptions of exercises helps patients better understand how to perform them correctly. Written instructions can clarify important details such as body position, movement patterns, and proper form. This understanding reduces the risk of incorrect execution, minimizes the potential for injury, and ensures that patients receive the intended benefits from each exercise.
Exercise descriptions serve as a valuable reference for patients, especially when they are performing exercises independently at home. By having a clear description of each exercise, patients can refer back to it whenever they need a reminder of the correct technique. This helps them stay on track with their home exercise program and encourages compliance, as they feel confident in their ability to perform the exercises accurately.
04
Use Home Exercise Program Software
HEP software also facilitates communication between patients and therapists. Therapists can provide feedback and address concerns remotely, while patients can share progress and difficulties. This ongoing interaction strengthens the therapeutic relationship and ensures guidance and support throughout the rehabilitation journey.
HEP software also enables comprehensive documentation, since it automatically records exercise details, aiding clinical assessments, insurance claims, and research. Additionally, patient information can be securely stored and shared among healthcare providers involved in the patient’s care.
05
Measure Patient Adherence
Monitoring adherence also provides valuable data for evaluating treatment progress over time and identifying correlations between adherence levels and treatment success. This data-driven approach helps therapists make informed decisions about treatment adjustments and resource allocation. Additionally, measuring adherence fosters effective communication and collaboration between patients and providers, allowing for personalized feedback and addressing any challenges or concerns. Overall, incorporating adherence measurement into physical therapy practices enhances treatment outcomes, optimizes patient engagement, and improves the quality of care.
06
Customize Home Exercise Programs as Needed
On top of that, customization ensures that exercises are suitable for the patient’s abilities and fitness level; some patients may also have physical limitations that require modifications. This ensures that the exercises are challenging enough for progress and recovery but not too strenuous to cause harm.
Additionally, customization takes into account the patient’s preferences and lifestyle factors. By aligning the program with their preferences and fitting it into their routine, therapists increase adherence and long-term engagement.
Furthermore, customization accommodates the patient’s progress and adjusts the program accordingly. As patients improve, their abilities and needs change. Therapists regularly assess progress and make modifications to continue challenging and facilitating improvement. This flexibility ensures the program remains effective throughout the rehabilitation journey.
Strength Training
Substitute barbell squats with bodyweight or wall squats using a stability ball if the original exercise is challenging due to lack of equipment or discomfort. These alternatives continue to target lower body muscles while being more manageable and accessible.
Balance and Stability
Original balance exercise of standing on one leg for 30 seconds can be adjusted to be performed while brushing teeth or cooking. This merges the exercise into daily activities, thereby promoting regular practice.
Flexibility
Instead of a static hamstring stretch, therapists may set a goal for patients to touch their toes within a certain timeframe. The program can be adjusted with additional stretches and progress tracked, fostering motivation and adherence. Note: These are illustrative examples. Actual program adjustments should be personalized and supervised by a qualified physical therapist.
07
Encourage Regular Feedback and Open Communication
When patients understand how specific exercises contribute to their recovery or functional improvement, they are more motivated to perform them consistently which, in turn, enhances patient engagement and compliance. That’s why Physiotec places a strong emphasis on providing knowledge through resources and literature for patient education.
- Weekly or biweekly check-ins via phone call, video call, or email.
- Providing a feedback form that patients can fill out at their convenience.
- Leveraging HEP software that has built-in communication tools for instant messaging and video calls.
- Encouraging patients to share their experiences, thoughts, and concerns at each appointment, making sure to listen empathetically and provide appropriate responses.
- Creating a safe and non-judgmental environment where patients feel comfortable discussing their progress or any obstacles they are facing.
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