Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2018; 28(01): 20-31
DOI: 10.1055/s-0043-120527
© Georg Thieme Verlag KG Stuttgart · New York

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

Empfehlungen zur Verbesserung der Adhärenz zu Heimübungsprogrammen: Eine Übersichtsarbeit
Caroline Bachmann
1   Department of Health Science and Technology, ETH Zürich, Zürich, Switzerland
Peter Oesch
2   Department of Physiotherapy, Kliniken Valens, Valens, Switzerland
Stefan Bachmann
3   Department of Rheumatology, Kliniken Valens, Valens, Switzerland
› Author Affiliations
Further Information

Publication History

received 18 May 2017

accepted 28 September 2017

Publication Date:
18 December 2017 (online)


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+).


Fragestellung Das Ziel der Übersichtsarbeit ist eine systematische Auflistung von relevanten Faktoren, die die Adhärenz zu Heimübungsprogrammen beeinflussen können, und aus diesen Resultaten Empfehlungen abzuleiten, wie die Adhärenz gesteigert werden kann.

Material und Methoden Es wurde eine systematische Literaturrecherche in den Datenbanken Web of Science Core Collection (Bibliothek der ETH Zürich), PubMed und PEDro durchgeführt. Die folgenden Suchkategorien wurden verwendet: „physiotherapy“, „home-based exercise“, „adherence“, „effectiveness“, „motivation“ und „barriers“.

Ergebnisse Es konnten 38 Studien identifiziert werden, von denen nach der Titel- und Abstractanalyse noch 14 Arbeiten in die Übersichtsarbeit einbezogen wurden. Die Resultate zeigen, dass vor allem intensive soziale Unterstützung und Führung durch einen Physiotherapeuten, geringe Anzahl instruierter Übungen (<4), hohe Selbstmotivation und Selbstwirksamkeit und nicht vorhanden sein von psychologischen Einflüssen wie Hilfslosigkeit, Depressionen und Angstzustände zur Adhärenz zu einem Heimübungsprogramm beitragen können.

Schlussfolgerung Durch eine gute Begleitung des Patienten durch Physiotherapeuten, durch die Instruktion von 2 – max. 4 Übungen und durch Erhöhung der Selbstmotivation und Selbstwirksamkeit der Patienten kann die Adhärenz zu Heimübungsprogrammen relativ einfach gesteigert werden (Recommendation level B+).

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