How many home exercises do you prescribe?

16 Oct 2020

For this blog inspiration, I give credit to Silvia Lavallee (PT) from Manitoba, Canada.  She forwarded an elbast that the Manitoba Physiotherapy Association sent out to their members on this topic.

Here’s the full blurb:



Clinical Pearl

Submitted by Sarah Conci, Instructor, CoRS

How many exercises should I prescribe in a patient’s home exercise program?

A question that came up recently for me was: How many exercises should I include in a patient’s home exercise program? While the answer to this would generally depend on a number of factors and need to be considered in a patient-centered way, I wondered if there was any research to guide me. I was able to find 2 articles that both suggested improved compliance and improved quality of performance of home exercise programs when 2 or fewer exercises are prescribed. So, the answer, and clinical pearl, is: when prescribing home exercise programs, include 2 or fewer exercises!

References: 

Eckard, T., Lopez, J., Kaus, A., & Aden, J. (2015). Home exercise program compliance of service members in the deployed environment: An observational cohort study. Military Medicine, 180(2), 186–191. https://doi.org/10.7205/MILMED-D-14-00306 

Henry, K., Rosemond, C., & Eckert, L. (1999). Effect of Number of Home Exercises on Compliance and Performance in Adults Over 65 Years of Age. Physical Therapy, 79(3), 270–277. https://doi.org/10.1093/ptj/79.3.270

Well, isn’t that interesting!  I always used to say, never more than what fits on one page if you are writing out exercises.  My suggestion was always 3 or 4.  So, it’s interesting to me that 2 or less is the ‘winner’ in this category!



Really, it makes sense though, doesn’t it?  1. Even if you write it out, people forget all of the exercises.  2. People aren’t very inspired to do exercises (maybe they’re more inspired to do their dog’s exercises rather than their own, however!) 3. I’ve seen people get carried away with exercise prescription just because they know 10 exercises for the glutes… so clients get all 10.



Yes, we know that exercise is key to recovery.  However, if the owners (or patients themselves) don’t do ANY of them, have we accomplished anything?



My caveat to this finding would be that if you have a client that comes in asking for MORE, and their dog is doing well, and you think it’s appropriate, then why not give them a couple more?



Oh, the ‘human element’ makes it so complicated, doesn’t it?!

On that note, have a great week everyone!



Cheers!  Laurie