A Study into the Barriers to Physiotherapy Treatment Adherence

Lusio HQ was forwarded a very interesting report from a study into what barriers there are to sticking to prescribed physiotherapy programs.  Carried out in the UK in the early 2000s, the initiators of the study were motivated to look deeper into some of the figures that they had seen in other studies.  Figures like 14% of physiotherapy patients not returning for follow-up appointments and up to 70% not doing what had been prescribed in their appointment.

Connection to Lusio

Such an interesting topic for all of us I’m sure, and it is no surprise that such studies are carried out to anyone who knows the origin story of Lusio Rehab.  Young Arshiathe 5 yr old boy in Iran and the inspiration behind the first Lusio lightbulb moment, was a classic example of someone who faced barriers to doing his physio.  Let’s be honest, we all know that it is hard to always follow what our clinician directs us to do.  Yet it’s for our own benefit; so, why is it so?

The Study Groups

The study was wide ranging, covering 20 separate groups of people, all with a variety of clinical diagnoses.  Seven of the groups were comprised of osteoarthritis/rheumatoid arthritis sufferers attending physio; four were investigating groups with lower back pain; three studies included athletes, while two studies researched fibromyalgia sufferers.  There were a number of further clinical situations in other studies but they all investigated at least one aspect of treatment adherence including attendance at appointments, following home exercises and in-clinic adherence.


So what did they find?  Across all the groups they were able to isolate a number of key areas that lead people to find it difficult to fulfil what had been asked of them by their clinician.  

Pain - pain was a clear barrier to doing / completing exercise.  This seems entirely logical and I have to say, from my own experience, I have always found clinicians to be very clear about only doing exercises within the limits of what is comfortable.

Prior Levels of Physical Activity - if prior to needing physiotherapy treatment one’s baseline level of physical activity is low, then it is highly likely that adherence to prescribed treatment will be impacted.

Self-Esteem - the studies found that low self-esteem was often a clear barrier to completing treatment programs.  They went on to say however that strategies to address this could include agreeing realistic expectations, setting treatment goals and positive reinforcement.

Anxiety, Depression and Helplessness - whilst the studies found clear evidence of these mental states being barriers to treatment adherence, the report made a point of highlighting the feedback loop between pain and depression.  If the message can be got across that exercise is an effective way of countering both low mood and negative thinking, whilst also improving pain and function, then much could be achieved in terms of improving adherence.

Social or Family Support / Activity - those who experienced low levels of social activity and / or family support also found it hard to adhere to prescribed programs.

Lusio HQs Take

What was so interesting for us at Lusio HQ about this report was that all of the findings seemed very intuitive.  We also feel it’s important not to feel any guilt about whatever it is that might hinder adherence to treatment programs.  It is what it is and life can easily get in the way of the best intentions.  If I may go back to little Arshia for a moment; his family found it very difficult to give him the support he needed at home to do his therapy.  No shame on them, life is busy and it’s not easy to make time.  Armin, our Head of Tech and the brains behind LusioMATE, was only too delighted to be able to help the family in the best way he could at the time.  A simple remote controlled car, that moved when Arshia did his flexion / extension exercise, was all that the young lad needed to find some joy in his therapy program.  Furthermore, it was all that Armin needed to know that within his crude early prototype was an idea that could be leveraged to help many more people break down the barriers to therapy program adherence.

LusioMATE’s very existence is all about breaking down those barriers.  We want all those who need to do physical therapy each and every day to improve the quality of their lives to be able to find FUN and motivation by playing games with LusioMATE.  We hope that the platform will make it easier for families to support each other and be involved with whatever physical therapy needs that exist within the family unit.  As Lusio grows, so too will the Lusio Family and we want that to be as supportive to each other as it can possibly be.  

All in all this was an excellent study and report for us to read, as it just confirms to us that we are moving in the right direction.  When it comes to physical therapy adherence, barriers are just there to be broken!


If you'd like to read the full study you can find it - here.

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