HEP Adherence Research

Research and statistics on Home Exercise Program (HEP).

Background research was done on statistics and why patients don’t perform prescribed physical therapy exercises. A particularly useful source was a Ph.D. dissertation titled “Patients’ Mental Models and Adherence to Outpatient Physical Therapy Home Exercise Programs” by Jon J. Rizzo (2015) from the University of Connecticut-Storrs. This paper focused on mental models, or mapping of prior experiences to current situations, as a way to find the root cause of why patients do not adhere to physical therapy HEP. The purpose of the paper was to explain how mental models relate to decision making, describe how mental models relate to experiences and adherence, and discuss issues with mental models in relation to physical therapy and therapists [1]. The paper highlighted a simplified process on how mental model formation leads to adherence in patients in HEP as seen below.

 

This framework of why certain patients do not adhere to home exercise program gives the team insight into specific factors that could impact pursuing this topic in the future. The paper also presented a study that showed certain aspects of mental models that affect patient decisions in physical therapy the most. These factors were identified to be realized  results, or outcomes directly from an event, anticipated results, or calculated positives and negatives in patients minds, social cause, or valued others as a motivating force, and value of convenience, or how convenient a task is [1].

Another Source we used for statistics was a paper titled “Predictors of compliance with short-term treatment among patients with back pain” by Alexandre et. al. (2002) This paper found that in a study of back pain 51% of patients had a high amount of compliance with attending physical therapy sessions, but only 35% of high compliance with at home exercises [2].  These results showed how few patients actually are able to comply with their at home physical therapy exercises. This confirmed the information given to us by physical therapist interviews we conducted at Ohio State. Another study performed by Shumway-Cook et. al (1997) highlighted the benefits of using actually performing physical therapy, as fall risk decreased with fully adherent patient by 33% and only 11% with partially adherent patients [3].

 

References:

[1] J.J. Rizzo, “Patients’ Mental Models and Adherence to Outpatient Physical Therapy Home Exercise Programs,” Ph.D. dissertation, Univ. of  Conn., Storrs., CT., 2015.

[2] N. M. C. Alexandre, M. Nordin, R. Hiebert, M. Campello, “Predictors of compliance with short-term treatment among patients with back pain,” Pan American Journal of Public Health, vol. 12, no. 2, pp. 86-95, 2002.  

[3] A. Shumway-Cook, W. Gruber, M. Baldwin, S. Liao, “ The Effect of Multidimensional Exercises on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults,” Journal of the American Physical Therapy Association, vol. 77, no. 1, pp. 46-57, Jan. 1997.  

 

 

Home Exercise Equipment

Therabands

Therabands were used in all the physical therapy locations we shadowed in and mentioned as a way for patients to do at home physical exercises. Theses therapy bands and very cheap and have different values of force to stretch to 100% Elongation, as seen in this chart, taken from the website below. The bands are able to provide positive and negative force in a variety of muscles.

The photo above shows a chart describing the the resistance of the different colors. It was taken from the Preston Home Medical Supplies Online website, which is linked below.

Thera Bands Resistance Exercise Bands

 

Angle Incline

One of the devices we saw at Mill Run Rehabilitation Center was an ankle incline. This ramp was able to stretch the calf muscle of a patient and work out the lower legs. A more robust version is listed below. This version featured a way to change the angle of the board, grip surface, and a means to change the angle, all within a simple, fold up package.

https://www.4mdmedical.com/index.php/catalog/product/view/id/213793/s/adjustable-ankle-incline-board-plastic?CAWELAID=120141310000056386&CAGPSPN=pla&gclid=Cj0KEQjwqMHABRDVl6_hqKGDyNIBEiQAN-O9hEEgPZoAB9OssaoLPdoNaNLj-3RG-VPk0qzLSAWy1BgaAojA8P8HAQ

 

Weighted Bars

At Mill Run Recreation Center, the team learned that weighted bars are used as phyiscal therapy tools. many bars exist in the market place, and all feature a color system for determining weight. The ones viewed have a PVC wall and outside grips. The price for these are relatively high, these ones being $27.00 per bar.

http://www.medshop.com/clinton-pt-weight-bar-46086.html?fee=1&fep=45887&utm_source=google_shopping&utm_campaign=main_feed&option=CL-4707-70&gclid=Cj0KEQjwqMHABRDVl6_hqKGDyNIBEiQAN-O9hMxeIlRo57RMFQuxIW_9-_xwlu0505BBEj8kQ-cRLQaAq0T8P8HAQ