Qualitative analysis of the factors affecting Home Exercise Program (HEP) adherence among clients with chronic musculoskeletal pain

Abstract

Purpose of the study. This study aimed to identify factors influencing adherence to HEP among clients with chronic musculoskeletal pain. Methodology. Clients with chronic MSK pain attending the physiotherapy outpatient department of a tertiary-care teaching hospital were recruited. Ten clients who consented to participate were interviewed in-depth, on a one-on-one basis. A semi-structured interview guide was used to explore experiences and perceptions of performing the exercises prescribed in the HEP. The audio-recorded interviews were transcribed and analyzed thematically. Results. Four major themes - purpose for adherence, influencing factors, facilitators, and barriers, emerged. Each of these domains had multiple sub-domains that resulted in the mapping of the sixteen explored factors. Conclusion. Adherence to a HEP is chiefly influenced by individual factors, clients’ interactions with the physiotherapist, and the prescribed exercises. These findings may facilitate the Health Care Professionals involved with the clients to prescribe exercises better, improve adherence rates, and provide health & wellness coaching as appropriate, to make physical activity and exercises a non-negotiable component of the clients’ lifestyle.