Every PT & OT in outpatient practice knows the frustration…

Your patients tell you they want to get better and return to doing the things they love. Those same patients come in to each follow-up appointment and tell you they haven’t been doing their home program.
The physical therapy literature suggests that up to 70% of patients are non-adherent to their home exercise programs: for these patients, their follow-up visits may be the only time they are performing any therapeutic activities. (1) Despite this pattern, the average number of in-person visits in rehabilitation is decreasing each year, and there is a growing emphasis on improving patient self-management. (2)
Rehab providers must find creative ways to encourage patient adherence to their plan of care, and in particular, to the home programs that will allow patients to contribute to their own recovery. In this article, we’ll consider an important tool in the battle to improve patient adherence: customization of the home exercise program (3). Let’s discuss:
1. Why you should customize every patient’s home program
2. How to customize HEPs without wasting time or energy
3. How customization can save your practice money

Customization: A Key Driver of Patient Satisfaction and Outcomes

How to Create Custom Home Programs without Exhausting YourselfElsewhere on the blogHow to Integrate Medtech With Human Touch for the Best Patient Experience, we’ve discussed how patients prefer personalization to automation in healthcare. (4) Across all fields of healthcare, there is an increasing demand for customized care and shared decision-making between providers and patients. (2)

Rehabilitation professionals must be prepared to embrace these changes and provide individually tailored programs for their patients. Let’s consider three key reasons to make an effort to customize each patient’s program:

  1. Not all bodies respond best to one type of exercise.
    • While it’s well established that everyone can benefit from physical activity and exercise in some way, genetics research suggests that some bodies will respond better to certain types of exercise than others. (5) For example, patients with elevated blood sugar may need to emphasize aerobic conditioning, while those looking to lower their cholesterol levels may benefit more from high intensity interval training. (5)
  1. Customization can improve patient adherence to HEPs.
    • By establishing a custom HEP with patient input and agreement, you can improve the chances that the patient will adhere to their prescribed program (3). If the patient feels that their opinion was considered and valued in the designing of their program, they are more likely to invest their time and energy performing it.
  1. Personalization increases patient’s confidence in their ability to perform their HEP independently.
    • Person-centered care requires that providers consider the needs and values of the patient first and foremost when designing a plan of care. (6) As a therapist, you may think you’ve built the perfect home program for a patient, but if that program includes too many exercises and the patient is totally overwhelmed, they are unlikely to comply with it. (7)
    • Ensuring that a patient is confident in their ability to complete each component of their HEP is key: nothing is more discouraging to a new patient than an initial HEP that is leagues beyond their capabilities. (8) Start small and simple, and build upon the program over time as the patient gains confidence.

Keep your Sanity: How to Customize Home Programs without Wasting Time or Energy

At this stage, you may be thinking, “Of course, I’d love to create the perfect, personalized plan for every patient, but who on earth has time for that?!?” To which we say, “You do!” Here are the keys to making custom prescription quick, easy, and hassle-free:

  1. Narrow down your plan to the 2-3 most important exercises.
    • Research from the military suggests that even in highly disciplined patient populations like active duty service members, a home program of more than 2-3 exercises can be too daunting to complete. (7) Consider how this might translate to your patients who have very little exercise experience: the fewer exercises you can prescribe, the better!
    • Creating a truly efficient and concise HEP will challenge your clinical reasoning: it’s certainly much easier just to hand your patient a packet with 20 generic exercises. However, it’s likely that those print-outs will end up in your patient’s recycling bid: wouldn’t you prefer that they perform a couple key exercises faithfully and well?
  1. Make use of telehealth technology to maximize prescriptive efficiency.
    • The AC Health app is built with busy providers in mind: it allows you to record exercises and instructions during a treatment session: you can teach the patient their exercises and assign them in the app at the same time. Your HEP prescription is finished before the patient leaves the clinic, and you’re spared the laborious process of finding and editing stock exercises in other programs.
    • The app also allows you to quickly send motivational message to encourage your patients who are struggling to stay consistent: this type of extrinsic support can be vital when patients have yet to develop the internal motivation they need to adhere to their program. (1,9)
  1. Leverage your clinical experience to create a library of your most-used exercises.
    • Despite all this talk of customization, it’s undeniable that there are some exercises that work really well for a large number of patients. With the AC Health app, you can record and save common exercises to your unique provider library.
    • Sometimes changing an exercise’s parameters is all the customization you need: in these cases, you can select an exercise from your provider library and then easily modify sets, reps, and hold times in the patient’s private care plan.

How Customization with AC Health Earns your Clinic Cash

In addition to saving you time, building customized home programs with AC Health can help improve your practice’s bottom line. By using a single, streamlined app, you can record each exercise exactly as you’d like it to be performed, with all your own cues. You no longer have to pay for several unique HEP platforms just to access to the two or three exercises you really like on each.

With the time you’ll save on documentation and the design of individualized HEPs, you may find you have time to schedule more paying clients per day. Additionally, personalization increases patient satisfaction, and satisfied patients tend to refer their friends and family: providers who use the AC Health app often see referrals increase as current clients share their experiences with their physicians and social circles.

From improved patient adherence and outcomes to decreased documentation time and cost savings, personalizing your clients’ home programs comes with a myriad of benefits for your practice and its patients. To learn more about how to commit to customization with the AC Health app, schedule your free training session today!


(1) Tack, C., Grodon, J., Shorthouse, F., & Spahr, N. (2021). “Physio anywhere”: digitally-enhanced outpatient care as a legacy of coronavirus 2020. Physiotherapy, 110, A26–A28. https://doi.org/10.1016/j.physio.2020.07.004
(2) Rawlinson, G., & Connell, L. (2021). Out-patient physiotherapy service delivery post COVID-19: opportunity for a re-set and a new normal? Physiotherapy, 111, 1–3. https://doi.org/10.1016/j.physio.2021.02.001
(3) Adherence to Home Exercise Programs. (2021). Physiopedia. https://www.physio-pedia.com/Adherence_to_Home_Exercise_Programs#cite_note-Gaikwada-14
(4) Longoni, C., & Morewedge, C. (2019, October 30). AI Can Outperform Doctors. So Why Don’t Patients Trust It? Harvard Business Review. https://hbr.org/2019/10/ai-can-outperform-doctors-so-why-dont-patients-trust-it
(5) Personalized Exercise? (2020, August 3). NIH News in Health. https://newsinhealth.nih.gov/2020/07/personalized-exercise
(6) American Physical Therapy Association. (2018). Commitment to Person-Centered Services. https://www.apta.org/siteassets/pdfs/policies/commitment-to-person-centered-svcs.pdf
(7) Eckard, T., Lopez, J., Kaus, A., & Aden, J. (2015). Home Exercise Program Compliance of Service Members in the Deployed Environment: An Observational Cohort Study. Military Medicine, 180(2), 186–191. https://doi.org/10.7205/milmed-d-14-00306
(8) Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E. (2010). Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. Manual Therapy, 15(3), 220–228. https://doi.org/10.1016/j.math.2009.12.004
(9) Gaikwad, S. B., Mukherjee, T., Shah, P. V., Ambode, O. I., Johnson, E. G., & Daher, N. S. (2016). Home exercise program adherence strategies in vestibular rehabilitation: a systematic review. Physical Therapy Rehabilitation Science, 5(2), 53–62. https://doi.org/10.14474/ptrs.2016.5.2.53