A Mixed Methods Analysis of Patient Adherence to Home-Based Physical Therapy Exercises

Objective: The purpose of this study was to explore how a variety of personal and provider factors might be related to adherence to home-based exercises in a rehabilitation setting. Methods: This study used survey methodology and mixed methods analyses to examine adherence to home-based exercises among a sample (N = 117) of outpatient physical therapy patients. Findings: Hierarchical logistic regression determined previous adherence to home-based exercises, self-efficacy, motivation, and social support-explained significant variance (56%) in adherence to current home exercise prescription. Additional variables that had small but significant contributions were sex, education, and therapeutic alliance. Qualitative content analyses found participants frequently reported a lack of time as a barrier and indicated receiving both emotional and instrumental forms of social support; they also highlighted the importance of good communication with the therapist. Conclusions: A useful strategy to prepare patients for being adherent to home-based exercises is multistage goal setting, and rehabilitation educators and professionals might consider how to incorporate effective goal setting into curriculum and practice in order to prepare patients for potential barriers, develop self-efficacy, and identify social supports who can assist in goal commitment and achievement.