A PTA’s Guide to Creating an Effective Home Exercise Program

Physical therapy is amazingly effective in treating a wide range of health conditions. During treatment sessions, physical therapists and physical therapist assistants (PTAs) have many treatment methods and tools at their disposal to help patients increase mobility, strength, and coordination.

However, the majority of outpatient physical therapy patients only receive formal PT sessions once a week at most. To maximize their recovery, it’s vital for patients to continue their rehabilitation between treatment sessions by following a home exercise program (HEP).

Following a patient’s initial evaluation by a physical therapist, PTAs can be instrumental in creating home exercise programs, demonstrating how to perform them, and motivating patients to stick with them over the long term. In this article, we’ll learn more about HEPs and explore some tips PTAs can use to create effective exercise programs and encourage patient adherence.

Looking for a more general overview of a career as a PTA? Check out our in-depth guide on how to become a physical therapist assistant.

Understanding the Basics of Home Exercise Programs

Home exercise programs are a critical component of almost any PT patient’s recovery. HEPs encourage continuity of care between physical therapy sessions, empower patients to participate in their own recovery, and can make a significant difference in patient outcomes.

On the other hand, when patients don’t follow their HEP, they may experience limitations or setbacks in their recovery. Patients may avoid sticking with their home exercise program for a variety of reasons, including pain, frustration with a perceived lack of progress, or negative previous experiences with physical therapy.

By communicating with their patients, understanding their individual needs, and establishing realistic expectations, PTAs can help patients overcome these obstacles and understand how following their HEP can lead to a faster and more complete recovery.

Conducting the Initial Patient Assessment

Conducting patient assessments falls under the scope of practice of a licensed physical therapist, though PTAs may observe and assist during initial evaluations. In addition to investigating a patient’s symptoms and limitations, a good assessment will also include a thorough discussion of their history and the goals they have for physical therapy.

PTs and PTAs take a holistic view of all the information gathered during an initial assessment to inform the home exercise program they design for each patient. Catering an HEP to each patient’s individual needs can help improve adherence and build trust between the patient and their PT providers.

How to Set SMART Goals

Goal-setting is an essential part of physical therapy, and a valuable opportunity for PTAs to connect with their patients. Goals help define what success looks like for each patient, and keeps them motivated throughout what can be a long and difficult recovery process.

From physical therapy to project management, the SMART framework is a commonly used method to ensure effective goal-setting. According to SMART, goals should be Specific, Measurable, Achievable, Relevant, and Time-Bound. Let’s take a look at what each of those mean in the context of physical therapy.

Specific: Goals should target a specific need or area of improvement. Instead of something general like “increase strength and reduce pain,” consider goals based on a patient’s real-life needs, like “be able to reach overhead and put away dishes on the top shelf.”

Measurable: Measurable, objective goals help demonstrate patients’ progress (and determine if changes may be needed to their treatment plan). Measurable goals may look like increasing the range of motion by a specified amount, walking a certain distance, or maintaining balance for a given period of time.

Achievable: Though patients may be tempted to set lofty goals for their recovery, setting reasonable milestones keeps expectations reasonable and gives patients the satisfaction of accomplishing a series of small goals throughout their healing journey.

Relevant: Goals should always be tailored to each patient’s lifestyle, needs, and capabilities. A recovering athlete will have very different goals for their recovery from an older adult looking to maintain their independence.

Time-Bound: Adding a time element to your goals can keep patients motivated to continue their progress and also helps PTAs and physical therapists know if the patient’s goals or overall care plan may need to be adjusted.

Designing a Home Exercise Program

Like the initial patient assessment, creating a patient’s overall treatment plan falls under the scope of practice of a licensed physical therapist. However, once the supervising PT has diagnosed the patient and prescribed a plan of care, PTAs may be involved in creating a home exercise program to work toward their recovery goals.

To design an effective home exercise program and make it easy for patients to follow, PTAs should apply the principles of exercise prescription, commonly abbreviated as FITT (which stands for Frequency, Intensity, Time, and Type).

• Frequency describes how often exercises should be performed for maximum effectiveness.
• Intensity refers to the desired amount of effort—for example, the amount of weight used for a particular exercise.
• Time describes the overall duration of each exercise, whether that’s a number of reps or a specific amount of time spent on each exercise.
• The type specifies the exercises to be performed as part of the rehabilitation routine.

Home exercise programs look different for each patient, but a well-rounded HEP typically includes a combination of strengthening exercises and mobility work—and, for some patients, balance exercises or functional training designed to replicate a particular task.

When designing a home exercise program, it’s critical to tailor the recommended exercises to each patient’s condition, health history, and comfort level with certain movements. It’s important to keep in mind that many patients may not have access to specialized exercise equipment, so routines that incorporate household items or the patient’s home environment can encourage more consistent adherence.

How to Communicate With Your Patient

Though a well-designed home exercise program goes a long way, effective communication is often what helps patients stick with their HEP. By teaching patients the “why” behind the exercise program they’ve been prescribed, PTAs can help them understand how each exercise contributes to their ultimate health goals. Using plain language and avoiding medical jargon whenever possible also avoids confusion or misunderstandings.

Leading by example is another powerful way to connect with your patients. PTAs should perform exercises themselves to demonstrate proper form and then supervise and make necessary corrections as the patient imitates what they’ve been shown. This hands-on time builds trust between the patient and their PTA and ensures the patient knows how to perform their HEP safely.

Providing patients with easy-to-follow instructions for each exercise makes it easier for them to remember key information. Visual aids like photos or video tutorials are also extremely useful, whether they’re given as printed pages or links through an online patient platform.

Besides ensuring patients know how to properly perform their home exercise program, PTAs should also communicate openly with patients to understand and overcome barriers to adherence. Whether patients are afraid of pain, losing their motivation, or struggling to fit their HEP into a busy schedule, candid discussion with their PTA enables collaborative problem-solving based on their individual circumstances.

The Importance of Monitoring and Adjusting the Program

While physical therapists and PTAs will do their best to create a home exercise program that works for the patient’s needs, rehabilitation is rarely a linear journey. Most of the time, a patient’s HEP will be adjusted throughout their recovery based on how they’re responding to treatment. Regular check-ins that measure a patient’s progress are a key part of that process, whether it’s through in-person therapy sessions or virtual appointments.

PTAs often measure things like strength, balance, or range of motion during in-person appointments. Patients can also take additional steps like using a diary, exercise log, or tracking app to record their progress and how they’re feeling from day to day. Gathering as much information as possible enables fine-tuning a patient’s HEP for the best results and helps overcome any concerns or challenges.

Telltale signs that a patient’s home exercise program might need to be adjusted include a plateau or lack of progress, consistent pain during or after exercises, significant shifts in strength or mobility, or major changes in the patient’s lifestyle or therapy goals.

PTAs are not generally authorized to make changes to a patient’s treatment plan, as that’s the responsibility of their supervising physical therapist. However, PTAs should communicate any observations or patient concerns to their PT and collaborate closely to ensure any modifications to the HEP are working as intended.

How to Promote Patient Adherence

Patients who follow their home exercise plan generally have significantly better outcomes in physical therapy, which is why promoting patient adherence is so crucial for PTAs. Teaching simple habits like setting calendar reminders and establishing a daily routine can help patients stay on track with their exercises.

Often, the mental challenges of a long rehabilitation are at least as taxing as the physical aspects of following a HEP. Positive reinforcement, successful goal-setting, and involving family members or caregivers can all be powerful motivational forces for patients during their recovery. By understanding each patient’s barriers to adherence and working collaboratively to overcome these obstacles, PTAs can inspire their patients to be proactive participants in their own healing.

Develop Your PTA Skills at Provo College

For home exercise plans and every other aspect of physical therapy, PTAs are essential in implementing the plan of care for each patient. Their skills, compassion, and communication empower patients to take ownership of their rehabilitation, and to stay the course when the journey becomes challenging.

To thrive as a PTA in a changing healthcare landscape, choosing a training program that’s focused on your success can make all the difference. The physical therapist assistant program at Provo College equips future PTAs with the knowledge and skills to make a difference for their patients and the resources to thrive in their own careers.

Besides instruction from experienced PT professionals, you’ll also have access to a career services team that can help you make the transition from the classroom to the clinic and provide ongoing support as your career progresses. And with an accelerated 21-month program, you could be treating patients in less than two years!

Wondering about the different potential career paths available to you with a PTA degree from Provo College? Check out our guide to the top 8 physical therapist assistant jobs.