Recommendations for Improving Adherence to Home-Based Exercise: A Systematic Review

Purpose The aim of this review is to list the factors that influence adherence to home-based exercise, and to make recommendations about how to improve adherence. Materials and Methods A literature search was performed in Web of Science Core Collection (Library of ETH Zurich), PubMed and PEDro databases. The following search categories were used: "physiotherapy", "home-based exercises", "adherence", "effectiveness", "motivation" and "barriers". Results A total of 38 studies were identified and title and abstract analysis was performed. 14 studies were included for further analysis. The factors found to contribute to adherence to home-based exercise programmes are: intensive social support and guidance from a physiotherapist; prescription of a low number of exercises (<4); high levels of self-motivation and self-efficacy; and a lack of psychological influences, such as helplessness, depression and anxiety. Conclusion Adherence to home-based exercise could be increased relatively simply, through provision of good support of the patient from physiotherapists, instruction of 2 to a maximum of 4 exercises, and by increasing the patients' self-motivation and self-efficacy (Recommendation level B+).