I'm currently on my musculoskeletal prac. Just last week alone, I encountered 2 patients who were very reluctant to do any home exercises. As the home exercises (strengthening and stretching) are important to maintain any progress achieved during treatment (soft tissue massage and mobs), the patients turn up at every session no better than the previous one. It is very frustrating to see the hard work put into improving the patients' conditions go down the drain every week. As a physio, it seems to me that all I can do is educate and negotiate with the patient (which the previous students have all tried to no avail with these 2 patients). I still gave it a go with education this week but have the impression that both patients are going turn up this week without having done their HEP.
Since this is only the beginning of my second week in this prac, I would really like to get some compliance and improvement while I'm here. Would really appreciate any advice from anyone who's had similar experience and success with improving compliance in the outpatient setting!
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Hi Steve,
I reckon every student and physio is faced with this hurdle!!! Sorry these ideas are prob not not new, but any how :)
I found compliance inc. in such senarios when prescribing "less standard" stretches (for lack of a better word)- I'll elaborate in a sec...
pts more impressed and curious to try new stretches not seen before (gives u more credibility too). Provided they were not 2 difficult lol.
Sometimes pts were infact doing the stretches but lacked regularity and the length of time they held them was not sufficient. Therefore they feel no change and stop all together.
Gave stretches they could hold in shower/ bed/ watching TV. More likely to remember.
For example, couch potatoes I gave "hip opening stretches" used in yoga positions, that allow them to sit and watch TV while ingrossed in a program or add break. If u dont know what I mean should be on net or just ask me to show u.
For pts that were able, gave more active stretches. So explained to tighten the opposing mm -antagonist- to facilitate stretch of targeted mm. Explained where mm's attached- inserted for them to have good understanding.
For example, quads during HS stretch and also TA to brace back etc.
If pt does it properly in the session a few times should see ROM gains and feel better so inc.'s compliance... but unfortunately time constraints often prevent this hey :)
I am quite obessed with yoga, ha ha so get into the stretches promo... I'll stop blabbering...
Good luck with your busy prac,
Kymba
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