Exercise adherence: knowing isn’t doing

Why is long-term exercise adherence so difficult to achieve? The question has long eluded easy answers – but physical therapists may need to pay more attention to patient perceptions of why adherence breaks down, a focused symposium heard on Sunday.

Sarah Dean from the United Kingdom, chairing the session, said there was a big gap between people knowing what to do and actually doing it. “Please don’t go away thinking that the only answer is education. We know there are people who want to do their exercises but still don’t do them,” she said. “Adherence typically requires health behaviour change.”
 
Helen Frawley from Australia explored women’s adherence to pelvic floor exercise programmes. Her research examined perceived barriers to adherence among both patients and professionals.
 
“Don’t assume you think the barriers are the same,” she said. Both groups agreed that patient-related factors – not the therapy itself – were the most important factors in non-adherence.
 
But whereas clinicians tended to see the biggest problem as being patients forgetting to do their exercises, patients themselves thought the main problem was not seeing any benefit to what they were doing.
 
“Perception of significant benefit is a really important driver for long-term adherence,” she said. “As health professionals, we need to address patient perceptions of minimal benefit.”