Importance of Home Exercise Program Compliance
During my career as a physical therapist, I have heard many comments such as " I'm too busy" or "I'm too tired" or " I have pain" or" I forgot" or " I just don't want to do them". These are just some of the reasons why people do not perform their home exercise program. Although the majority of excuses are valid most of the time, it does not take away the importance of a consistent home exercise program.
When I started working at STAR 25 years ago, the norm was patients were seen three times/week at our office. Co-pay at that time ranged from $5 to $20 per visit. Today with most patients having either a high deductible insurance plan or co-payments averaging $40 to $50 per visit, it is very difficult for people to attend more than one to two times per week even though most need close guidance with their injury or condition. That's what makes home exercise compliance even more critical.
Home programs can be as simple as watching your posture and using ice or heat initially. Frequency with home program can range from performing exercises every one to two hours, 4 to 5 times per day, once a day or once every 2 to 3 times per week. For example, a person with an episode or acute low back pain may benefit from specific exercises to be performed every hour or two while a patient who underwent an ACL reconstruction or rotator cuff repair will be required to perform exercises 4 to 5 times per day which will likely progress to a strengthening program 2 to 3 times per week.
Feedback regarding how home programs are tolerated is essential in the rehabilitative process. Therapist will modify/upgrade your individualize program depending on patient’s objective measures, function and subjective complaints. Many patients will not perform their home exercise because of pain they are presently experiencing. I instruct my clients to perform their prescribed exercises even if they are in pain as three possibilities may occur: 1) they feel better after performing the exercises, 2) they feel the same, or 3) it increases their pain or symptoms. If 1 or 2 occurs, home exercises should be continued but if symptoms increase, modifications or possibly discontinuation of certain exercises may be indicated.
It has been my experience that patients who are compliant with their prescribed home exercise program tend to progress and recover much quicker from their condition thus reducing the time and dollars spent attending supervised physical therapy sessions. Bottom line... Do your homework!
John Ciavaglia, P.T.