Promoting patient cooperation with exercise programs. Linking research, theory, and practice

Abstract

Managing patient-nonadherence with prescribed exercise regimens is not an uncommon task for physical therapists working with individuals with arthritis. Yet little is known about the factors that influence patient adherence with exercise programs or therapist knowledge and use of theoretically based adherence management techniques. Survey research with physical therapists and patients was used to provide a database for further insight into the barriers experienced in implementing exercise programs in clinical practice. In this paper, we suggest that the cooperation with an exercise regimen is mediated by the patient's belief system and requires a therapeutic process of mutual inquiry, problem solving, and negotiation between the therapist and patient. Concepts from research, theory, and practice are integrated into a Process Model for Patient-Practitioner Collaboration for use in clinical practice.There is evidence that noncooperation or a lack of compliance or adherence with arthritis treatment recommendations is a major problem that can affect patients' health status, yet much remains to be learned about the factors that influence patient cooperation [I-

Comparison of Mini-squats and Straight Leg Raises in Patients with Knee Osteoarthritis: A Randomized Controlled Clinical Trial

“…[15,26] It has been well documented that commitment to a home exercise program is essential for maintaining the long-term benefits of exercise in OA patients and controlling the adherence to these exercises is an important responsibility for clinicians working with these patients. [24,35,36] Unfortunately, a limitation of our study was that the exercise adherence rate was not evaluated in our sample.…”

Predictors of compliance with short-term treatment among patients with back pain

“…Other studies, for patients with other diseases and treatments, have also shown poor adherence to recommended exercise programs (13,25). Several studies have attempted to identify factors, beliefs, and attitudes that influence exercise adherence (39)(40)(41). There are indications that exercise adherence in low back pain treatment is as poor as with other diseases or treatments (42)(43)(44).…”

Adherence and satisfaction of rheumatoid arthritis patients with a long‐term intensive dynamic exercise program (RAPIT program)

“…In comparison, adherence rates to medical regimens range from 16% to 84% (11). Reported determinants of adherence to short-term exercise regimens in patients with RA are self efficacy, previous exercise habits, attitude towards the exercise program, and (perceived) severity of the disease (12)(13)(14)(15)(16). Data regarding adherence or determinants of adherence to long-term exercise programs in RA are sparse.…”