The benefits of physical therapy are immeasurable. Physical therapy changes the lives of patients every day, enabling them to return to their lives with greater ability. The skilled work of physical therapists, certified athletic trainers and physical therapy assistants provides patients with improved outcomes after surgery, greater mobility and decreased risk of future injury. However, patient compliance remains an issue.
The Importance of Compliance
Physical therapy requires a level of compliance not found in most other fields of medicine. Unlike medical treatments that require little time or personal effort such as surgical interventions or medications, physical therapy often requires a long-term commitment of both time and physical effort to reap the full rewards. A patient that misses treatments, does not perform home exercises or fails to give a full effort to exercises in treatment is unlikely to have as positive an outcome as the patient who follows through.
The Barriers
A great deal of research on patient compliance has been reported. Although there are many barriers to therapy, a few stand above the rest as both common and correctable. A person's perception of control over his injury and outcome have a great impact on adherence to physical therapy. Someone with what is described as an "external locus of control" does not feel that his actions impact his outcome. Length of treatment also seems to have significant impact, with persons being treated for chronic injury being less compliant than those treated for acute injury. A tangible goal may motivate patients in therapy for acute injury. As can be expected, complex programs are more difficult to adhere to than simple ones. On a positive note, a good relationship with a therapist appears to improve adherence to exercise programs.
Change in Perception
If a person perceives rehabilitation to be too difficult, or too inconvenient to fit into her daily schedule, she is much less likely to continue therapy. Patient education and involvement are the keys to changing negative and often false perceptions. Goal setting, especially involving a favorite hobby or task, can provide the motivation needed to reach a positive outcome; a recreational athlete may be more likely to complete a task that she can correlate to an activity she enjoys. For example, the cyclist who understands that doing heel slides now will help her return to a full cycling motion later is more likely to adhere to a physical therapy program. Baseball players will feel more connected to treatments that incorporate baseball tosses or swinging a bat; dancers will respond to the inclusion of barre techniques. Involving a patient in the planning phase by including exercises related to a loved activity, like golf, hunting or dancing, requires building a personal relationship with a patient and frequent monitoring. Both of which improve adherence to physical therapy.
Patient Education Is Key
An informed patient is a compliant patient. A person who does not fully understand the benefits of a particular exercise or activity is unlikely to continue to perform it. Knowing that this exercise will improve your balance or that exercise will stabilize your throwing arm can be the driving force that keeps you on track. Be your own best advocate. Ask questions, and do your homework. You as a patient have more control over your outcome than anyone else. Use the resources you have at hand to take the helm and get the greatest results possible.
