How Do You Promote Home Exercise Program Adherence?

Physical therapists know that patients have better improvement and recovery when following their home exercise program (HEP). But home exercise programs are often the first thing to drop when life is overflowing with work, family, and other responsibilities. Is there a better method that helps patients achieve HEP compliance?

In this post, we’ll explain why HEPs are important, some barriers to HEPs, and tips on how to overcome those barriers. We will also explore the ways in which Exercise.com’s physical therapy home exercise program software can significantly improve your patient’s HEP adherence! Contact our support team to learn how our software can improve your patient and business management. 

Benefits of Performing Home Exercise Programs

Depending on the diagnosis and insurance, patients treated in an outpatient clinic generally have therapy one to three times a week. This leaves four to six days in which the patient does nothing for rehabilitation. It only makes sense that performing a few exercises on a daily basis to build strength, coordination, and flexibility would enable patients to recover at a faster rate.

Home exercise programs do just that!

Patients who complete their HEPs are more likely to excel in their therapy sessions, have fewer recovery setbacks, and are able to be discharged earlier from therapy. HEPs are the tools therapists use to help patients manage their condition for long-term health benefits. Patients can always resume their HEP to prevent an injury, if they exacerbate their injury, or to maintain overall conditioning.

Barriers to Performing Home Exercise Programs

Despite your best explanation of benefits and exhortation to your patient to perform their HEP, there’s often resistance. In fact,  research reveals that only 35% of patients fully adhere to their HEP! This shockingly low statistic should facilitate change in how therapists assign HEPs.

Before getting frustrated with your patients over their lack of adherence, it’s crucial to discover why patients are hesitant to comply. Is it really only that life is busy, or are there underlying barriers to compliance?

There are numerous reasons why a patient shirks their HEP, but below are some common explanations. Use your clinical questioning skills to dig deeper and understand the true reason behind their noncompliance. This may take extra time, but your patients will experience a faster and more successful recovery if you don’t rush this crucial step.

Pain

There’s the old joke that PT stands for physical torture. Unfortunately, many patients think this is the case! When patients believe that physical therapy exercises and stretches are supposed to be painful, they may not express when their HEP causes them pain.

Additionally, many patients live with constant pain, so it’s understandable that they would avoid a HEP that increases their daily pain. A painful HEP can also increase stress and anxiety for patients, adding another reason for poor adherence.

Depression

There are countless reasons why patients feel depressed. For some, it may be related to their chronic pain or acute injury. Patients may feel helpless or hopeless in recovery. They may struggle to believe they can have a successful recovery and that attempting recovery is futile.

Others may be depressed for reasons besides their injury. Among many possibilities, there may be stressors in work or family life, financial struggles, or diagnosed clinical depression. Mentally, the patient may not be able to devote time and space to their physical improvement.

Present Low Physical Activity

For patients who had a low level of physical activity prior to their evaluation, performing a regular exercise program can be intimidating. It can be a major life adjustment for someone who does not have a habit of routine exercise. Additionally, weakness, poor endurance, and/or soreness may discourage the patient from continuing.

Lack of Social Support

Sometimes the patient can be motivated to perform their HEP but simply not have the support. This can happen in two forms.

First, patients can lack support in their circumstances. For instance, your patient is a single parent who doesn’t have time to do their HEP while the kids are awake and too exhausted after the kids go to bed. They need a more detailed game plan for accomplishing their HEP than a patient who is retired.

Second, patients can have a lack of support socially. Their spouse, boss, co-workers, friends, or family might not understand the necessity and benefits of a HEP and dismiss its importance. This can encourage the patient to also brush it off.

Unanswered Questions

Many therapists have routine HEPs for specific diagnoses. Even if you give a unique HEP to every patient, it’s still easy to rush through the program because the exercises are second nature to therapists. However, this leaves patients with many questions that they may not voice. The patient leaves their session with a shaky understanding of their HEP, which often results in the patient avoiding their HEP.

Tips for Home Exercise Program Compliance

Now that we’ve identified some barriers to HEPs, how do we overcome them, and what other methods can we utilize for better HEP compliance?

Overcome Perceived Barriers

Let’s examine some practical ways you can encourage your patient to move past their hesitancy to HEPs:

• Pain: Start by dispelling the myth that exercises should be painful. Patients will be more inclined to comply when they know their HEP shouldn’t cause them pain. Be sure to explain that performing their HEP should reduce their pain. As the patient progresses in therapy, it’s important to check in with the patient on their pain level during their HEP.
• Depression: Lend an empathetic ear to your patient’s struggles. If possible, work to eliminate barriers that are causing your patient to feel demotivated. Even if you can’t fix the problem, you gain your patient’s trust by listening well.
• Present Low Physical Activity: Take time to help the patient find a specific time in their day to perform their HEP. This will help with habit formation. Explain some hurdles the patient may experience, such as weakness and soreness, and encourage them to continue despite discomfort.
• Lack of Social Support: Brainstorm with your patient how they can successfully perform their HEP. If they don’t have time to do it, they won’t, so don’t rush past this step! If they lack social support, explain that their HEP enables them to be a better spouse, employee, and friend.
• Unanswered Questions: Therapists often hand their patients a printout at the end of their session with a few home exercises and save very little time for instruction or answering questions. Give every patient an explanation of their HEP and allow patients time to ask questions. Some patients need more help than others; some may benefit from performing every exercise the way they would at home. This is time-consuming but worth the reward of better HEP compliance!

Every patient has unique strengths, fears, and circumstances. Stay creative in your patient care because a personalized approach pays off in the end! For more on overcoming perceived barriers, you can check out our article on how to motivate your patients.

Less Is More

Don’t overwhelm your patient with dozens of exercises or a long exercise session. In fact, one study found that patients were most compliant with their HEP when they were given only two exercises. Choosing the most important two or three exercises will be better in the long run than assigning half a dozen exercises that will rarely be performed.

If it’s not possible to limit the HEP to a few exercises, try two sets of exercises. The patient can perform each set once a day (if they have time) or alternate days. Aim for exercise sessions to be 15 minutes or less.

The goal is for the patient to not be overwhelmed by the number of exercises or the time it takes to perform them. When patients feel confident in performing a few exercises and know they don’t have to block off a large chunk of time for their exercise session, they are more inclined to comply.

Patient Education After the First Session

Most therapists give a general rundown of the benefits of a HEP in the first treatment but neglect patient education in subsequent sessions. However, patients need reinforcement and encouragement to continue their HEP, especially as they begin to recover and it’s easier to slack off. Instead of giving an educational lecture, try asking your patient questions such as:

• How do you feel after performing your HEP?
• Are you able to do more everyday activities?
• Have you noticed the exercises becoming easier?
• Are you having better endurance?
• Are you having less pain?

Questions along these lines give you an easy opportunity to boast about the benefits of HEPs and extend patient education. Using their answers, guide your patient to see how their HEP is helping them achieve their goals. When patients realize how HEPs improve their everyday life, there is an automatic motivation for compliance!

Provide a Highly-Personalized HEP

Patients are more likely to perform their HEP when they know it has been personalized specifically for them. Instead of simply handing your patient a printout with a standard HEP for back pain, use Exercise.com’s physical therapy software to give that personalized touch patients want.

With our software, you get a HEP creator with a library of professionally-made demonstration videos providing clear instructions on all your HEP exercises. (You can also upload your own videos to increase personalization and promote your business!) Simply select the exercises for your patient’s HEP and enter reps, weights, sets, and more. These are automatically sent to your patient via your custom-branded HEP app for them to log anytime, anywhere.

Provide Accountability

Accountability is an important tool for breaking or starting any habit. It’s also one of the best motivational methods to encourage better HEP adherence. When patients know they are accountable to their therapist for performing their HEP, they are more inclined to comply.

However, sometimes verbal accountability still isn’t enough. Not wanting to discourage their patient, many therapists are quick to downplay noncompliance. While the therapist’s intentions may have been good, in the long run, this reinforces to the patient that their HEP is optional.

This is where Exercise.com’s physical therapy software comes in! Patients have a higher level of accountability with their therapist by using the HEP logger because their therapist sees all their logged exercises and sessions. If your patient lacks good social support, this accountability can be the difference between compliance and noncompliance.

Studies show that patients are more likely to comply when HEPs are attractively presented. Our HEP logger does just that! Far from a paper handout that’s been copied one too many times, our logger is fun and easy for patients to use. Because HEPs are sent the app, their HEP is always at their fingertips! This convenience enables patients to complete their HEP just about anywhere.

Additionally, patients can communicate with their therapists inside the app. This further encourages compliance because it removes the excuse of not understanding the exercise. If the patient has questions after watching the video, they can message their therapist for clarification and stay on track.

Utilizing these tips increases the chances of your patients adhering to their HEP. When patients complete their HEP, they have better recovery outcomes and higher satisfaction, which makes your business more profitable.

The physical therapy software from Exercise.com is HIPAA-compliant and includes everything you need for patient and business management. Not only can you create personalized HEPs, but you also receive features like automated billing, online training, scheduling, custom-branded apps, and more! Our software helps you focus less on admin tasks and more on patient care.

If you’re interested in learning more about how our software gives your patients a personalized therapy experience and grows your business, request a demo today!