Factors influencing compliance with home exercise programs among patients with upper-extremity impairment

Abstract

Objective: Patient cooperation and satisfaction with home exercise programs are important for successful outcomes of intervention. This study investigated factors from three models to predict increased compliance and satisfaction with home exercise programs: the Model of Human Occupation (MOHO), including the volition subsystem (interests), habituation subsystem (roles), and performance subsystem (reported physical capacity); the Health Belief Model (HBM), including perceived barriers, benefits, self-efficacy, and severity; and the Health Locus of Control (HLOC).

Method: Sixty-two outpatients at an orthopedic upper-extremity rehabilitation facility completed a battery of questionnaires and self-report instruments, including a health belief survey to assess HBM factors, the Multidimensional Health Locus of Control Scale, the Modified Activity Profile to assess the performance subsystem of the MOHO, a demographic questionnaire (including roles), a report of home exercise, and a satisfaction scale of their therapist's treatment. Compliance was determined by comparing participants' report of exercises performed to exercises specified on their medical chart.

Results: Stepwise regression identified two predictors of compliance: perceived self-efficacy and internal HLOC, R2 = .16.

Conclusion: Results supported the role of the MOHO's volition subsystem, but roles and physical capacity--representing the habituation and performance subsystems of the MOHO--did not contribute significantly to the prediction of compliance.