Understanding barriers to adherence to home exercise programs in patients with musculoskeletal neck pain

Review written by Dr Julia Treleaven info

Key Points

  1. Individual patient experiences and beliefs can impact home exercise program (HEP) adherence in patients with neck pain.
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Several conservative interventions are recommended for the management of non-specific neck pain (1). Often a multimodal approach consisting of manual therapy and exercise is recommended (1). Importantly this often requires prescription of a home exercise program (HEP) to improve neck pain, disability and function (2). However, poor adherence (up to 70%) to a HEP is commonplace and can affect the overall outcome (3).

Several multifactorial reasons for poor adherence have been identified in musculoskeletal disorders but less so specifically for neck pain. Understanding individual patient beliefs, perceptions and attitudes towards HEPs might further improve our understanding regarding exercise adherence for patients with neck pain.

The aim of this study was to qualitatively assess patient thoughts and beliefs regarding HEP performance and quantitively define the relationship between adherence of HEP’s and functional outcomes and identify variables that impact adherence.

Poor adherence (up to 70%) to a home exercise program is commonplace and can affect the overall outcome.
This study suggests that therapist communication with patients and exercises aligning with physiotherapeutic goals is of vital importance for patient compliance with their home exercise programs.


  • This was mixed methods study using a semi-structured patient interview in 25 individuals for qualitative data and a retrospective chart review for 187 patients for quantitative data.
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