Kirk-Sanchez N, Stults K, Gaunaurd I; Florida International University, Miami, FL and Mercy Hospital, Miami, FL. sanchezn@fiu.edu.

PURPOSE: Successful long-term outcomes of physical therapy intervention often depend on the extent to which patients or clients adhere to home exercise programs. The purpose of this study is to describe adherence to home exercise programs in the first month after discharge from an outpatient physical therapy episode of care. This is a preliminary report of a study of both short-term and long-term adherence to exercise programs. SUBJECTS: Subjects were 84 adults receiving outpatient physical therapy from a hospital-based rehabilitation center. Subjects were 67 % female, with an average age of 66 ± 16 years. METHODS: Subjects were interviewed at the time of discharge from physical therapy to collect demographic information. Medical records were reviewed to determine co-morbid conditions, length of episode of care, and number of physical therapy treatments. All subjects received a written home exercise program during their episode of care. Subjects were contacted by telephone weekly for four weeks and were asked to identify the number of days they completed at least 50% of their home exercise program. Subjects were categorized by primary diagnosis. DATA ANALYSIS: Data were analyzed using descriptive statistics. Differences between the three largest groups based on primary diagnosis were explored using analyses of variance. RESULTS: Subjects had an average of 1.1 co-morbid conditions, an average length of stay of 45 days, and received an average of 17 physical therapy treatments. Forty eight percent of subjects had lower extremity disorders, 12 % had upper extremity disorders, 5% had cervical or thoracic disorders, 16% had lumbar disorders, 8% had neurological disorders, 9% had lymphedema, and 2% had other diagnoses. Subjects performed at least 50% of their home exercise programs 4.0 days per week. Results of analyses of variance demonstrate that the lower extremity, upper extremity, and lumbar musculoskeletal groups had no differences in average age, number of co-morbid conditions, length of episode of care, or number of physical therapy treatments. Subjects in the lumbar musculoskeletal group performed their home exercise programs less frequently than subjects in the lower extremity musculoskeletal group (2.3 vs. 4.6 respectively, F = 3.28, p = 0.05). CONCLUSIONS: Patients with lumbar musculoskeletal disorders seem to have poorer adherence to home exercise programs, despite similarities in other aspects of care. Further research should explore other differences in these patients that may account for this disparity. FUNDING SOURCE: Foundation for Physical Therapy.

Copyright 2004 by the American Physical Therapy Association

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