Non-adherence to prescribed home rehabilitation exercises for musculoskeletal injuries: the role of the patient-practitioner relationship

J Rehabil Med. 2014 Feb;46(2):153-8. doi: 10.2340/16501977-1241.

Abstract

Objective: To identify which factors best explain non-adherence to home rehabilitation exercises (HRE) for patients with musculoskeletal injuries.

Design: Cross-sectional study.

Methods: Participants (n = 87) aged 17-91 years completed questionnaires measuring demographic and injury-related information, self-efficacy, personality, health locus of control, patient-practitioner relationship, optimism, health value and adherence to HRE. In addition, each participant's attending physiotherapist assessed the participant's adherence and effort during the appointment.

Results: A hierarchical regression with 3 steps (step 1: disposition; step 2: cognitive factors; step 3: patient-practitioner relationship) and adherence to HRE as the dependent variable was conducted. The factors in step 3 were the most significant and explained 16% (p < 0.001) of the variance in adherence to HRE. In addition, a high score for patient neuroticism was found to correlate with poor adherence to HRE.

Conclusion: These preliminary results suggest that the patient-practitioner relationship is the best predictor of adherence to HRE, and that improving patient perception of the clinician's productivity, communication of information and trust during consultations may improve adherence to HRE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / rehabilitation*
  • Patient Compliance* / psychology
  • Physical Therapists
  • Professional-Patient Relations*
  • Self Care
  • Surveys and Questionnaires
  • Wounds and Injuries / rehabilitation*
  • Young Adult