Correlates of Exercise Compliance in Physical Therapy

Background and Purpose. This correlational study describes factors that are related to patient compliance with exercise regimens during physical therapy. We investigated whether patient compliance was related to characteristics of the patient or the patient's illness, to the patient's attitude, or to the physical therapist's behavior. Subjects and Methods. Of a random sample of 300 physical therapists in private practice in the Netherlands, 222 therapists responded to a questionnaire survey. Eighty-four respondents also made audio recordings. Materials of the study were 1,931 registration forms, 1,837 audio-recorded sessions of physical therapy sessions, and 1,681 patient questionnaires. Results. The results show that the three main factors related to noncompliance were (1) the barriers patients perceive and encounter, (2) the lack of positive feedback, and (3) the degree of helplessness. The first factor, the barriers patients perceive and encounter, shows the strongest relation with noncompliance. The results also show that noncompliance is more strongly related to the characteristics of the illness than to the illness, a bad prognosis is negatively related to compliance, and much hindrance of the complaint is positively related to compliance. There was no difference between men and women with regard to patient compliance, but less educated patients were slightly more compliant than more highly educated patients. Conclusion and Discussion. These correlational findings can be used to formulate hypotheses of cause and effect in future clinical research. Future research should take into account the type and efficacy of therapeutic exercise for different diseases. For physical therapy practice, it seems important that physical therapists carefully explore which problems patients encounter in their efforts to comply and that they seek solutions to those problems in mutual cooperation with their patients.