Patient Compliance in Physical Therapy Home Exercise Regimens

Abstract

Compliance and noncompliance with medical regimens have been the topic of medical concern and scientific investigations since the beginning of humankind. Medical compliance can be broadly defined as, "The extent to which a person's behavior coincides with medical or health advice" (Haynes, Taylor & Sackett, 1979, p.1). Medical noncompliance is the failure to comply to medical and health care advice. Compliance in physical therapy is of considerable importance because it is critical to the rehabilitation of an injury. If patients do not comply with the treatment regimen that physical therapists recommend, they are less likely to improve their condition (Ice, 1985). Most physical therapy patients are given a home exercise program to supplement their rehabilitation at the physical therapy clinic. Some studies have shown that only 64% of physical therapy patients comply with these short term home exercises (Sluijs, van der Zee & Kok 1993a). The purpose of this study is to investigate the basis for compliance and the causes of noncompliance with physical therapy home exercise programs and to investigate different ways to alleviate noncompliance. < This study will concentrate on curative, short term compliance in home exercises. Short term compliance is defined as, "compliance with the exercise regimen within the period of treatment", as opposed to long term compliance, which is "compliance after the treatment period" (Sluijs, 1991, p.194). Curative treatment is aimed toward a specific goal, usually recovery from an injury. Preventive treatment, on the other hand, has no specific goal - it is more of a process than a product (Sluijs, 1990). Preventive treatments involve exercises that are performed to prevent the recurrence of a previous injury or the incidence of a new injury. Curative treatments are often associated with short term compliance while preventive treatments are associated with long term compliance.