Written By: Chad Hensel, PT, DPT, MHS, CSCS
The Home Exercise Program (HEP) has been shown as one of the most fundamental and important aspects of therapy. We recognize that patient adherence leads to improved achievement of goals and therefore physical function (2). Additionally, that lack of adherence has been correlated to increased risk of exacerbations and less positive long-term outcomes! In order to maximize our outcomes, we must get BETTER at promoting patient compliance of the HEP.
Some suggestions from The Home Exercise Program (HEP): Design Strategies to Optimize Compliance and Outcomes:
#1 Consider applying what we have learned from pharmacology research—compliance is higher when a patient takes a smaller pill less frequently. If a patient had to take a large pill 3 times per day, compliance is reduced by as much as 45%. Where if a patient is asked to take a very small pill just one time per day—compliance is as high as 93%
#2 This same principle can be applied to the HEP for rehab: less is more. We are far more likely to have better compliance with a minimalist approach—1-2 exercises no more than once per day!
#3 Implementation of this strategy requires we have a better understanding of the type of learner our patient is: visual, auditory, kinesthetic or a combination? Here is a video to give you a quick assessment!
#4 Utilize technology already available to you — Apple Watch, Fitbit, Garmin, etc. Results can be downloaded and added into the patient chart!
#5 Consider prioritizing your HEP — what are the two most important movements you want them to master? Focus on this and then build from them!
For even more information and strategies, I invite you to join my Live Stream on May 17th, “The Home Exercise Program (HEP): Design Strategies to Optimize Compliance and Outcomes” where we will explore best practices to overcome common barriers and improve your patients’ compliance. If you can’t attend, no worries! Watch at anytime via On-Demand.
Explore online continuing education courses from Chad below:
A Rehab Professional’s Guide to Pharmacology
Bariatric Management Effective Assessment and Safe Treatment
Exploring Medications and Supplements and the Impact on Physical and Cognitive Function
High Intensity Interval Training (HIIT)
Utilizing Movement Analysis for Exercise Prescription: Part 1
Utilizing Movement Analysis for Exercise Prescription: Part 2
Visit summit-education.com for more information.
References:
Ricke E, Dijkstra A, Bakker EW. Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis. Front Sports Act Living. 2023 Mar 24;5:1035023. doi: 10.3389/fspor.2023.1035023. PMID: 37033885; PMCID: PMC10080001.
Azevedo DC, Ferreira PH, de Oliveira Santos H, Oliveira DR, Leite de Souza JV, Pena Costa LO. Association between patient independence in performing an exercise program and adherence to home exercise program in people with chronic low back pain. Musculoskelet Sci Pract. 2021 Feb;51:102285. doi: 10.1016/j.msksp.2020.102285. Epub 2020 Nov 4. PMID: 33257276.
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