4 Tips to Maximize Home Exercise Program Participation

Participation ina home exercise program (HEP) outside the clinic or training facility can be a substantial factor in a patient's positive and sustained long-term outcome. The following evidence-based tips can help achieve increased patient buy-in and adherence.

1. Provide Written and/or Video Instruction

Providing verbal instructions for your patients' home exercise program is important, but if youre not providing visual aids and/or videos, youre losing quality and adherence. Pictures and videos, like the examples below, give clearer performance instructions than words alone. At least one study showed that patients receiving additional written and illustrated instruction had a 77.4% adherence rate vs the verbal instruction only groups adherence rate of 38.1%.¹ This is no surprise considering reports estimate that patients retain only 40-80% of medical information from a visit, and of the retained information, only 50% is correct.²

Below is an example of both a web-based (on the left) and an app-based HEP (on the right). It is important to provide the HEP in your patients preferred medium: print, email, text, or app. The Medbridge HEP Builder and Patient Mobile App can provide programs in any of these formats.

[caption id="attachment_6140" align="aligncenter" width="775"] Web-based home program (l), and app-based exercise program (r).[/caption]

2. Less Is More

How many exercises do you give your patients on average? Evidence suggests that HEP adherence and performance inversely relates to number of exercises prescribed; meaning the greater number of exercises prescribed, the lower the adherence rate.^3,4 For example, a group of military-based patients demonstrated increased adherence to athree exercise HEP vs afive exercise HEP.³ Another study showed that a in a >65 year old population, a group prescribedtwo exercises performed better than a group prescribedeight exercises (there was no difference between the five exercise group).⁴ This question definitely needs additional study, but it suggests HEP prescription efficiency is beneficial.

3. Exercise History is Key for HEP Prescription

Know your patient. Are you treating an elite athlete, a weekend warrior, a mother ofthree who works full time, or a sedentary person? The weekend warrior with a good exercise background will likely be more adherent to the arobust and comprehensive HEP while your sedentary client may need asimpler program. The history allows you to apply your clinical judgement to the HEP size notedabove.

4. Make Your HEP Evolve

As healthcare reform lumbers forward, the number of available treatment sessions is decreasing, so the HEP definitely needs to serve as a primary intervention that grows and evolves throughout the episode of care. You should provide an HEP as early as possible and update it as your patient progresses. Medbridge can easily track your HEP in your EHR and updates can be made quickly with the individualized access codes. If your patient has the app or web-based HEP access, the HEP will update as soon as you save the program.

Putting these four steps togethercan lead to more efficient and more effective HEP. Plus, with tools like the Medbridge HEP Builder and corresponding Patient Mobile App, it's easier now more than ever to create programs that make a difference for your patients.