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COTA Thoughts

Educating Patients with Exercise

Published February 20, 2008 8:53 AM by Tim Banish
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Teaching an exercise routine to our patients is a good thing. But after you've taught a routine to your patients, how do you ensure they can follow through? I thought this would be a good subject to touch on today because I rarely see any exercise programs being handed out when I'm in the clinics, especially in LTC.

Expecting a patient to remember an entire exercise routine is asking a bit too much, and more so with older populations. Remembering your patient population is the first point to consider. If you're dealing with young adults, they will probably be able to remember several of the exercises. Completing the exercises correctly might be a different story though. I'm sure only a few would both remember and complete the entire routine as you instructed. If your patient is older, I'm sure the retention of what you just taught them will be even less.

Another thing I think about with exercises is variety. I really don't expect anyone to do the same routine every time they need to exercise, unless it's a specific injury. As human nature lends us to bore easily, I always try to have a couple of different routines that address the same deficit. I also find increased compliance doing this too.

So fire up those copiers! Dig out your old exercise routines and put them to use. Use one of the many popular programs out there that let you select cards to build a specific routine. Ask your colleagues for copies of routines. Search online, or use some of the Advance selection of free to copy and use programs. Just remember to follow up your teaching with handouts!

Until next time, hope all your thoughts are good,

Tim

 

 

posted by Tim Banish
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2 comments
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Lorraine-

Thanks for your comments. Mostly, Thanks for agreeing with my point of view!

Having exercise handouts is an important piece of the routine, I believe. Especially if there is any cognitive impairment. Being older myself, I know that the memory is not what it used to be.

Of course, I also like to see the handouts compiled in an orderly and neat manner to enable anyone to be able to follow it. I also like to offer several routines that address the same issues to decrease the chance ofthe patient becoming bored with exercise. I'm sure a study regarding patient compliance with exercise routines would show an increase if using handouts.

As far as handling several clients at once who need assistance, first I limit my co-treatments to 2 people (per CMS guidelines). I can always find a task that each can do independently while I work on higher level skills one person at a time. I try to split the therapy time with everyone so that they do 1/2 exercise and 1/2 ADL's, balance, cognitive, etc. as their plan outlines.

Tim Banish, COTA/L February 26, 2008 12:58 PM
Cincinnati OH

Hi Tim,

I hear you! I agree that most patients really need the handouts! I am speaking as an OT and as "the patient" and also is an adult who has some kind of challenge, undiagnosed of course, with coordination and mild kinesthesia issues.

Sometimes I don't know if I am doing an exercise correctly if it is new to me or takes coordination.

How can we expect a patient to remember the exercise program when they are possibly going through lots of stress due to the reason that they need therapy!?

That brings up another challenge that I have experienced. How do you handle working with several clients at once when they are at a status where they cannot do the routine independently?

Also, the internet is great to look up an injury to give a picture of where the patient's injury is located, for them to see.

I recently sent a patient home with a complicated sequence of compression bandages. I scribbled the sequence for the patient to use, with some pathetic drawings. She came back in to the clinic and had perfect replication with her bandages! I would like to see unofficially if compliance goes up with detailed instruction.

Thanks for the post!
Lorraine Calhoun, Lymphedema Specialist - OTR/L-CLT, Advanced Lymphedema Therapy Specialties February 25, 2008 9:55 PM
Langhorne PA

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