How to Improve Home Exercise Adherence-Use Just the Right Amount of Equipment

One of the most common challenges in physical therapy practice is getting patients to actually do their exercises at home. As I’ve written about previously, we see about a 50% adherence rate to home exercises, despite the low cost and time commitments of most programs. 

It is easy for us to dismiss patients as being lazy or illogical for not being able to perform a few minutes of exercise. However, I see this often with people who are otherwise hard working and highly motivated in other areas of life. I have worked with lawyers who work 10+ hour days, yet struggle to perform 10 minutes of home exercises. 

One of the lowest hanging fruits to help patients perform exercises is our choice of equipment. The amount and type of equipment impacts how likely patients are to adhere to the program.

Here are a few common barriers and how to address them with your choice of equipment:

  • The need to setup or find equipment decreases adherence. For some patients, the act of having to find or setup equipment makes them less likely to actually perform exercises. This might seem ridiculous, but when adding a new behavior to someone’s life, small hurdles such as having to wrap a band around a doorknob, can prevent adherence. With these patients, we need to ask questions about when in the day they might have time to do exercises, where, etc. Then pick exercises that have minimal equipment setup needs. Rather than a band resisted row at a doorway, the patient could perform bent over reverse flies without weight. 
  • When the “busyness” of the day makes them forget about performing exercises. Some patients actually perform exercises once they remember, but they just get caught up in the demands of daily life. Here, equipment such as a band or dowel actually serves as a visual reminder.  For example, an office worker might have a red band by their keyboard which cues them to perform a few band pull aparts when they take breaks during the day.
  • When the patient wants exercises that look specific and technical. Patients come to physical therapists for our professional expertise. For certain personalities, if an exercise seems too simple it actually cheapens its value. For example, performing forward shoulder flexion (lifting your arms straight out front) can feel just like it sounds, just lifting your arms out in front of you. However, if we assign a patient a D2 band resisted diagonal (lifting out front at a slight angle with a resistance band) this feels more technical and specific. The context of exercise matters. 

The choice of equipment depends on the specific barrier and personality of the patient in front of you. Our expertise as doctors of physical therapy goes behind our clinical skills. Seemingly minor decisions, such as exercise equipment choice, play a key role in our patients feeling better and returning to the activities they love.

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