Assessing patient intention to perform a home based exercise program for back and shoulder pain

Abstract

The prescription of exercise is a basic tool used in the physiotherapy management of many musculoskeletal conditions. For an exercise regimen to be successful, the patient must have the knowledge and skill to perform the regimen as well as an intention to do so. This study used the Triandis model of behavioral intention, a component of the Theory of Social Behaviour, to develop and validate a questionnaire measuring a patients' intentions to perform a prescribed home exercise program, and explore which variables of the model are significant predictors of patients' intentions. The questionnaire was developed based on patient interviews, cross-situational examples and professional experience. A total of 234 people being treated for low back or shoulder dysfunction in a teaching hospital were administered the new instrument. Results indicated the psychometric properties of the instrument met established criteria. All three variables contained in the model—perceived consequences, affect and social factors—were significant predictors of intention to exercise, yielding the regression equation Intention = 0.28 × perceived consequences +0.25 × affect +0.23 × social factors. This model was able to estimate 22% of the variance of the intention to exercise in this sample. The study highlights the complex nature of patient adherence to exercise programs and the need for physiotherapists to consider patient attitudes and beliefs in the process of prescribing home exercise programs for their clients.