By: Olayi Oyekanmi, PT, DPT, CSCS
As healthcare professionals, we want nothing more than to help you return to your prior level of function.
In order to be successful with your physical therapy (PT) program, there are several factors that come into play. The most important factor is your compliance with your prescribed home exercise program (HEP). An HEP is a group of exercises provided by your treating physical therapist designed to foster continued progress in strength, improve and sustain range of motion (ROM), and increase tolerance of functional activities. Compliance with your HEP allows you to continue to decrease your pain independently during and after physical therapy. Long term compliance with your HEP ultimately helps to prevent your pain from returning.
During your initial evaluation, your physical therapist will assess your mobility, strength, and overall ability to move. Using the results of these assessments, your PT will establish which impairments are most contributing to your pain. The determined impairments will help inform the interventions performed and the goals of the prescribed interventions are to ultimately decrease pain and improve pain free performance of activities. Interventions often include strengthening exercises, stretching exercises, balance exercises, manual therapy, etc. In order to maintain the progress made during each session, your physical therapist will prescribe some of the exercises to be performed outside of the physical therapy appointments.
According to this study by R. Campbell et. al., non-compliance with home exercises is multi-faceted and may be contingent on many internal and external factors.
“A number of the factors found to contribute to non-compliance with physiotherapy in this study have also been found in sociological research concerned with drug therapies, in particular that symptoms need to be perceived to interfere with life sufficiently to require treatment, and that an intervention needs to be perceived to be effective and to be suitable for incorporation into everyday life.”
Here are some other common reason patients report non-compliance with their home exercise programs (HEP), and some suggestions on how to overcome them:
“I don’t have enough time in my day” We understand you are busy with work and family obligations. Your physical therapist can help you devise strategies to include some of the exercises in your daily routine so you are able to be efficient with your time.
“I was in pain” Many times, patients may have flare ups of their symptoms and choose not to perform their home exercises. The HEP is prescribed to help alleviate symptoms. Following a flare up, take your time to perform the exercises. Of course, if the exercises increase your pain, stop doing them and consult with your physical therapist.
“I don’t understand what I’m doing” As many times as you need, ask your PT to review the exercises with you so you know you are performing them correctly. Also, ask your physical therapist why you are performing the exercises. Understanding the purpose of the exercises may give you that added incentive to perform them.
“Am I going to have to do this forever?” Yes and no. The goal of physical therapy as a whole is to help break the pain cycle, and get you back to doing the things you love without pain. We want you to learn about your body during the process and while you may not need to do your whole home exercise routine “forever,” we want you to have a strategy if your pain were to come back in the future. In some cases, we may recommend performing some form of a maintenance program for the rest of your life.
Check out these other tips from the American Physical Therapy Association (APTA) for patients and therapists to help improve HEP compliance.
It’s important to understand that a home exercise program is specifically tailored to each patient based on their impairments.
You should always consult with your physical therapist before adding or changing anything in your home exercise program and know that your physical therapist has put this program in place to help make your recovery as efficient as possible.