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ADVANCE Perspective: Physical Therapy & Rehab Medicine

The Compliance Factor

Published October 15, 2007 1:56 PM by Lisa Lombardo
It is not uncommon to hear PTs and PTAs discuss patient compliance. Therapists often get frustrated when they feel patients are not following treatment plans or doing what they are supposed to on their own to get through therapy.

But can clinicians' experience with patients who don't comply with treatment plans taint their view of other patients? Does frequent patient non-compliance influence whether or not you prescribe exercise for some patients-even if you know it would benefit them?

A new research study reports that weight training works just as well as running on a treadmill or biking to help the most important symptom of type-2 diabetes-long-term control of blood sugar, according to Canadian researchers (Reuters, Sept. 18, 2007).

The researchers-Dr. Ronald Sigal of University of Calgary and colleagues at the University of Ottawa-studied 251 people with type-2 diabetes age 39 to 70. None of the patients exercised regularly. They assigned them to one of four groups-one that did 45 minutes of aerobic training three times a week, another doing the same amount of resistance training, a group that did both, for a total of an hour and a half of exercise three days a week, and a fourth group that did no extra exercise. The exercisers used treadmills, exercise bikes or weight machines at a health club.

The volunteers liked the exercise-and stuck with it, Dr. Sigal said. "I think there is a widespread cynicism even among medical people that people will actually exercise," Dr. Sigal said, according to the report.

An interesting comment coming from a doctor. He seems to suggest that many clinicians might not prescribe exercise for patients simply because they believe the patients will not comply with an exercise routine.

The researchers of this study said doctors should prescribe exercise to every diabetes patient. PTs and PTAs are often the critical link that encourages patients to actually follow through with this prescription. Perhaps physicians should be more aware of this-and not give up on patients even before they start moving.

How do you get patients such as those with diabetes to comply with a necessary exercise plan?

posted by Lisa Lombardo


In addition to knowing the why, aids that make compliance easier help tremendously.  An perfect example is the webb's leg sling that holds the foot off the floor for non-weight-bearing situations. When the leg is beilng held up, you just comply.

Wayne Urban, Controller November 26, 2007 8:12 PM
Bedford OH

If the patient knows why he/she is doing it, they are more compliant- eg why do alternate hip abduction in standing?: it helps to improve weight shift and balancing on one leg and this is need to step into the bathtub. Giving examples of what is needed for daily activities helps the patient understand and thus stay more motivated with his/her HEP

Linda, Home Health - P.T., TLC November 21, 2007 6:30 PM
Deltona FL

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