Many conditions like stroke and arthritis affect a person’s ability to move and participate in daily living activities.
Such a person requires help from rehabilitation professionals, including physiotherapists and occupational therapists, to undergo a rehabilitation programme.
Rehabilitation is a process by which abilities such as range of motion, strength and endurance, are restored or maintained through therapy programmes.
For example, a stroke patient with limb weakness has to follow specific exercise routines in order to regain functions of the affected upper and lower extremities.
Doing it at home
Most patients attending therapy in rehabilitation settings like the hospital or rehabilitation centres, receive around one hour of therapy for at least once or twice a week.
This is often not enough for a therapy to be effective for certain conditions, therefore, the therapists will usually advise patients on further activities or exercises to be conducted by themselves at home.
This is known as the home programme, which ensures the continuity of the therapy and its effectiveness.
Complying with your rehabilitation programme at home is similar to adhering to your medication routine.
Just like taking pills twice a day, for example, the time spent on a home programme and the number of repetitive exercises has to be strictly followed as a part of your journey to recovery.
However, due to the lack of supervision and support, many patients struggle to continue therapy at home.
According to a study, patients’ non-compliance to their rehabilitation programme can be as high as 70%, which greatly impacts the outcome of therapy and has many negative consequences.
Common issues influencing a person’s motivation to continue with therapy are as follows:
This belief in our own abilities especially affects those with chronic conditions where little or no progress can be seen.
● Mental health problems
Depression and anxiety are common among patients with physical injuries or conditions, which leave them feeling sad, hopeless, worried or afraid all the time.
● Helplessness and poor social support
Helplessness refers to those who believe that there is no escape from their current condition.
Without proper support and the determination to proceed with therapy, patients are likely to become increasingly frustrated, leading to low adherence to the therapy programme.
● Overprotective significant others
Patients with families that discourage any activity that may cause discomfort are more likely to be less active and less adherent to a home programme.
● Pain during exercise
Some movements may cause pain, which often occurs during or immediately after exercise.
● Other barriers
This includes problems with transportation, life roles, schedules and memory function, as well as time or financial constraints.
So, what happens when you do not stick with your rehabilitation programme?
● Lack of progress
When a patient does not continue with the prescribed exercise routines at home, they will take longer to get better.
● Increased treatment costs
Frequent visits to the rehabilitation centre means more money spent on therapy and other related costs, such as transportation and unpaid leave.
● Medical complications
This may happen when the condition gets worse due to lack of preventive exercises.
For example, muscle-shortening due to lack of movement can lead to muscle contracture.
When muscle contracture occurs, rehabilitation may no longer be effective and surgery might be required.
Here are some strategies to motivate you to stick to your rehabilitation programme:
● Know your conditions and set realistic goals
Some conditions are progressive in nature, so acknowledging the nature of your condition may help you to anticipate your progress.
Discuss with your therapist how to set realistic goals in order to reduce your disappointment.
● Keep a diary
Having an exercise logbook may help in tracking all the effort and time you have put in to achieving your rehabilitation goals. You’ll be amazed at how far you have come.
It can also be a reference for your therapists to modify or intensify your home programme activities.
● Set reminders or an alarm
A daily reminder will ensure you remember when it is time to do your therapy activities.
Phone or alarm clocks are examples of devices that can help you to adhere to your therapy schedule.
● Getting involved in group activities or a support group
Social media groups or association groups are some of the various platforms that can be used to discuss your problems and keep yourself (and other members) motivated to continue therapy.
● Incorporate therapy into daily living activities
Occupational therapists are the key people to suggest individualised occupation-based activities to be conducted at home.
Activities can include daily routines such as doing laundry, gardening and cooking, according to your preference.
● Reward yourself
Treat yourself to something you really like when you accomplish certain goals, e.g. buy yourself a new shirt or go to a movie.
In summary, the home programme is a crucial part of rehabilitation and recovery is dependent on the patient’s perseverance and motivation to continue with therapy.