Abstract
Introduction: Designing and implementing home exercise programs (HEPs) is an essential component of nearly every physical therapist’s skillset. It promotes independence, expedites functional recovery, and provides the opportunity for patients to attain better outcomes without accumulating additional costs of extra appointment times. The lack of adherence to home exercise programs (HEPs) among patients of outpatient physical therapy practices has been a topic of concern in the medical field. Non- adherence attributes to a decrease in patient outcomes and increased costs for medical care. The purpose of this study is to explore barriers to HEP adherence among patients with shoulder pathology by using in-depth one-on-one interviews to gather information regarding this prevalent healthcare issue. Methods: Based on specific inclusion/exclusion criteria, eight participants were chosen via convenient sampling from four Southwest Florida private outpatient clinics to participate in one-on-one interviews. Interviews were audio recorded and transcribed onto Microsoft word, where the data was uploaded into qualitative analysis software for comparison and analysis. Results: Pain was the strongest negative influence of HEP adherence. Pain with activity was a particularly significant determinant for whether patients will adjust, modify, or skip their HEP. Satisfaction with the physical therapist, understanding of HEP instructions, and positive perception of the rehabilitation process were unanimously agreed upon by participants, indicating that these factors are not likely related to a patient’s decision to modify, reduce, or skip their prescribed HEP. Discussion: In general, patients may have been biased in their responses to the interview questions, given that there is likely the expectation that they should be completing their HEP in its entirety. Overall, each subject understood the importance of their HEP and attributed themselves getting better at least partially due to their HEP completion, yet total adherence was only reported from one subject out of eight.