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Home Exercise Program

July 7, 2010 by · Leave a Comment 

I’ve been interested in learning better ways to improve patients’ participation in their Home Exercise Programs.  Programs may be as simple as wearing a splint, sleeping or sitting differently, or doing specific activities to stretch or strengthen parts of the body.  Typically, a HEP provides pictures of exercises and a schedule of when to do each exercise and how many times to do them.  These are fine as far as they go, but they don’t provide much guidance in working the routine into ones daily routine – usually a routine that is literally packed with other priorities and habits.  Like medication routines, the compliance level with therapy home programs is probably around 30%.  I’d like to see compliance, or follow through around 60-80% and here are a few ways I think it can be done.

1. make specific measurable goals for each session – range of motion, ability to lift x number of lbs, pain level decreased from y/10 to x/10 on a painscale

2. use time limits and timers for routines rather than counts of repetitions, this allows for better planning into a busy day, allows for speed and agility differences, and allows for adjustments needed due to pain.

3. Associate or Pair Up exercises with something that’s already going on in the regular schedule: eg. phone calls using headset, work breaks/lunch, shower time, etc.

In addition, here are some ways I would like to help you with your home exercise program.

Provide a careful assessment of your current successes in self care – where are you succeeding?  How much internal and external support is needed to get you to do what makes a difference?

Present options for home exercises and self care and explore ways that these fit into your existing behavioral patterns and daily schedules.

Decide what measures you will use to determine how much exercise to do.

Providing you with measurement tools to use before and after exercises.  For example, many of patients have stiffness in the wrist and digits and the progress can be slow; so slow they don’t know if they’re making progress. However, if one carefully measures the range of motion before and after exercising, then even small advances can be seen.

Here’s something from the great ted.com that provides an example of someone really thinking hard about quality healthcare.

tedmed.com speaker thomas goetz, executive editor wired magazine

 

The larger issue of how patients use medical information, monitor their progress, and participate in their health care treatment is an important subject.  Additionally, I believe we all have something of value to offer one another, if just encouragement or the sharing of personal experiences around success and failures.

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