Why Patients Don’t Exercise – What’s a Therapist to do?


Suzanne Clark

Suzanne Clark

Post from Education Resources Faculty Member: Suzanne Clark

You do a great job putting together an exercise program for your patients with chronic disease. You teach them how to do the exercises and they return the demonstration. You give them a written program to do at home. When you see them again you say “let’s see how you’re doing with those exercises” and they either tell you they did not do them or when you ask them to demonstrate the exercises it’s obvious they have not been following through with their programs. This gets in the way of their progress and your ability to meet your goals. So you lecture that they need to do their exercises if they want to progress. You ask them if they have any questions and they say no but the non-compliance continues. What’s a therapist to do??

Fitting exercise into a daily routine is a lifestyle behavior change. Behavior change does not come easy for many people. Think about yourself – are you having trouble sticking to a diet or exercising the recommended 150 min per week?   It can be especially hard for people who are also trying to manage a chronic disease such as arthritis, diabetes, Parkinson’s Disease, CAD, or COPD. One of the ways to promote behavior change is to ask your patients what is getting in the way – what are their barriers. Perhaps your patients do not see how exercise is relevant to their goals. Have you asked what the patient’s goals are? Maybe they have fear that the exercise will increase their arthritis pain, induce their asthma or cause a heart attack. Cognitive issues could be impairing their ability to initiate or sustain an activity. You do not know what the barriers are until you engage your patients and ask. There are many other motivational techniques you can use to promote behavior change including adult learning principles, health literacy, goal-setting, and building confidence in their ability to change.  Exercise can help prevent chronic disease or slow its progress but it doesn’t work unless it’s used consistently.

In Education Resources new course; Evidenced-Based Therapy for Chronic Disease:  Intervention, Documentation and Reimbursement  you will learn to implement evidenced based treatment for chronic disease and how to motivate your patients to improve adherence to their exercise programs that will allow them to progress towards their functional goals.

Please share your successful tips on how to motivate patients 

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2 Responses to Why Patients Don’t Exercise – What’s a Therapist to do?

  1. April Cook says:

    I like your tip to look for the barriers instead of just lecturing that they need to do the exercises. Asking why and listening can give you the opportunity to really help the patient progress. Is it helpful to also talk to other members of their family so they have a support system at home that can help them do the exercises?

  2. Cheryl says:

    I have learned to limit HEP’s ( home exercise programs)
    to just 3 or 4 exercises, for greater compliance. Otherwise it can be overwhelming. This varies, of course.
    Also to add a fun element or cognitive cue, ie. during a commercial break or keeping daily log on calendar.

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