The article below appeared in the May 26th issue of Health with Perdana, a regular column in The Star by Perdana University faculty members. This week’s article is contributed by
HOME PROGRAMME FOR REHABILITATION – THE KEY TO SUCCESSFUL REHABILITATION PROGRAMME
What is a rehabilitation programme?
Many conditions such as stroke, arthritis, and others affect a person’s ability to move and participate in daily living activities. The person requires help from a rehabilitation professional including occupational therapists to undergo a rehabilitation programme. Rehabilitation is a process by which skills such as range of motion, strength and endurance are restored or maintained through therapy programmes. For example, a stroke patient with limb weakness have to follow a specific exercise routines to regain functions of the affected upper and lower extremities.
Why do some patients need a home programme for rehabilitation?
Most of the patients attending therapy at rehabilitation settings – either hospital or rehabilitation centres, receives around 1 hour of therapy for at least once or twice a week. This is often inadequate for a therapy to be effective for some conditions thus requires the rehabilitation professionals to advice on activities to be conducted at home, which is also known as the home programme. This programme ensures the continuity of the therapy and its effectiveness.
Challenges in adhering to home programme
Complying with rehabilitation programme at home is similar to adhering to your medication routines. Like taking the pills twice a day, the time to be spent on a home programme and the number of repetitive exercise has to be strictly followed as a part of your journey to recovery.
However, due to the lack of supervision and support, many patients are struggling to continue therapy at home. According to a research study, patients’ noncompliance to treatment can be as high as 70 percent, which greatly impact the outcome of therapy and introducing many negative consequences.
In addition, other common issues influencing a person’s motivation to continue with therapy are as follows:
1. Self-efficacy (Belief in our own abilities)
This is especially affecting those with chronic conditions where little or no progress can be seen.
2. Mental health problems
Depression and anxiety are common among patients with physical injuries or conditions, which left them feeling sad, hopeless, worry or afraid all the time.
3. Helplessness and poor social support
Helplessness refers to the people who believe that there will be no escape for their current condition. Without proper support and the determination to proceed with therapy will led to frustrations and low adherence to therapy programme.
4. 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 home programme.
5. Pain during exercise
Some movements may invoke painful sensation which often occurs during or immediately after exercise.
6. Other barriers
This include problems with transportation, time or financial constraints, life roles, schedules and memory function.
What are the effects of non-compliance to therapy?
Lack of progress
When a patient does not continue with the prescribed exercise routines at home, longer time will be taken to get better.
Increased treatment costs
Frequent visits to therapy setting means more money to be spent to therapy and other related costs such as transportation, unpaid leave and others.
This may happen when the condition gets worse due to lack of preventive exercises. For example, muscle shortening due to lack of movement which further leads to muscle contracture. When a muscle contracture occurs, therapy may longer be effective and requires surgical intervention.
Strategies to increase home programme adherence
Know your conditions and set realistic goals
Some conditions are progressive in nature so by acknowledging the nature of your conditions may help you to anticipate your progress. Discuss with your therapist in setting goals to reduce disappointment
Keep a diary
Having an exercise logbook may help in tracking the all efforts and time you have put in achieving your rehabilitation goals. You’ll be amazed at how far you have come. It can also be a reference for therapists to modify or intensify your home programme activities.
Set reminders or alarm
Daily reminder will trigger you to be aware of when it is time to do therapy activities. Phone or alarm clocks are examples of devices that may help you to adhere to your therapy schedule.
Involve in group activities/support group
Social media groups or association groups are of various platform to discuss on your problems and to keep each other motivated to continue therapy.
Incorporate therapy in daily living activities
Occupational therapists are the key people to suggest individualized occupation based activities to be conducted at home. Activities may include day to day routines such as doing laundry, gardening and cooking or according to your preference.
Get yourself a treat when you accomplish certain goals, by things that you really like, for example, buy yourself a new shirt or go to a movie!
In summary, home programme is a crucial part of rehabilitation and recovery is almost dependent on the perseverance and motivation to continue with therapy.