Home Exercise Adherence and Self-Reported Outcomes in Pro-Bono Physical Therapy

Introduction: There are unique challenges that underserved patients experience in attending physical therapy visits in a pro-bono setting. Thus, home exercise adherence likely plays a crucial role in patient outcomes. Purpose: The purpose of this study was to determine home exercise adherence rates associated with pro bono care, and to determine if there is a relationship between self-reported measures of change and pain with home exercise adherence. Methods: After initial evaluation, patients were assigned 4 home exercises. Instructional methods used for teaching the home exercises were standardized and based on the best available literature. On follow up visits, data was collected for home exercise adherence, self-reported pain scores (best pain, current pain, and worst pain), and self-reported global rating of change. Parametric and nonparametric statistical tests were run to determine if there were changes in self-reported outcomes over time as well as to investigate the relationships between these self-reported outcome measures and the exercise adherence rating score. Results: The investigators discovered that both the current and best pain scores were significantly decreased from pre-treatment to post treatment ( P < .016), and the median global rating of change score was improved. There were significant correlations between self-reported pain scores and the exercise adherence rating scale score( P < .05). Conclusion: Clinicians practicing in pro-bono physical therapy clinics should use known strategies to enhance home exercise adherence and encourage frequent visits to improve patient outcomes.