The Importance of Your Home Exercise Program

React_SI_Matt_Forte

While most patients are given a home exercise program during their first physical therapy visit, research shows us that less than 40% of patients regularly perform their home exercise program (HEP). A HEP is vital to the patient’s timely recovery, so why do the majority of people fail to follow through with their home exercises?
According to the CDC, some of the most common reasons people list for not participating in physical activity are:

  •       Do not have enough time to exercise
  •       Find it inconvenient to exercise
  •       Lack self-motivation
  •       Do not find exercise enjoyable
  •       Find exercise boring
  •       Lack confidence in their ability to be physically active (low self-efficacy)
  •       Fear being injured or have been injured recently
  •       Lack encouragement, support, or companionship from family and friends

 
Here are some suggestions to help tackle some of the barriers patients may face when trying to complete a home exercise program.

1)    Not enough time / inconvenient to exercise

A well-designed home exercise program should fit into your lifestyle so you do have time to perform all of the exercises. One way to fit your exercises in may be to break then up into smaller chunks throughout the day. For example, do half in the morning, half at night.  Or, try to fit your HEP into your lunch break.  Additionally, you should start to notice that as you get more familiar with the exercises you will become more efficient at completing them, so they should take less time.
 

2)    Exercise is not enjoyable / you find it boring

Unfortunately, some exercises may not be the most exciting, and if you crave the endorphin rush associated with sweating through a hard workout, your HEP may not always feel satisfying. That said, to build strength, you do need to challenge your body’s muscles, so if you are not somewhat fatigued after doing your exercises, you should discuss this with your physical therapist and it may be time to progress your exercises to become more challenging.
 

3)    Fear of being injured

None of the exercises in your HEP should cause you pain.  Keep in mind though, that there is a difference between muscle strain/exertion from a difficult workout and the type of pain you normally experience.  The exercises you do should not reproduce the pain for which you began seeking physical therapy.  If you are not used to being physically active, it is not uncommon to experience what is known as delayed onset muscle soreness (DOMS).  This is an uncomfortable feeling of muscle soreness that typically presents 24-48 hours after a strenuous workout.  The good news is that DOMS will generally resolve within a few days, and after you’ve performed the exercises a few times, it should disappear completely.
 

4)    Lack of confidence or support/encouragement

Your physical therapist is your partner in addressing your physical mobility concerns.  You should always feel as though you can call the clinic or bring up any concerns about your treatment plan, including your home program, with your therapist.  For example, you may want to periodically ask your physical therapist if you are still performing an exercise correctly.  Regular attendance at your therapy sessions is an important source of motivation as well. During your visits, you are often surrounded by other patients with similar goals, and it helps to see others working out in a supportive environment.
 
The biggest thing to remember is that your home exercise program should be thought of as part of your treatment plan (just like your therapy appointments) and,in a lot of cases, you should continue doing the exercises even after you have been discharged from therapy. Again, if you have questions or concerns about your home program, be sure to discuss them with your therapist.

 

References:
Forkan R, Pumper B, Smyth N, Wirkkala H, Ciol MA, Shumway-cook A. Exercise adherence following physical therapy intervention in older adults with impaired balance. Phys Ther. 2006;86(3):401-10.
Centers for Disease Control and Prevention.  Overcoming Barriers to Physical Activity.  CDC Website.  Available at: http://www.cdc.gov/physicalactivity/everyone/getactive/barriers.html. Accessed March 1, 2015.