Home Exercise Program (HEP) or Self-Management Program?

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Home Exercise Program (HEP) or Self-Management Program?

Patients are usually prescribed a HEP by their healthcare professional, to work on exercises at home to address their own impairments and functional limitations. These exercises are provided on a sheet indicating the number of sets and repetitions for each individual exercise.  However, should patients just follow the guidelines of a HEP, or should a HEP be viewed as something more meaningful?

HEPs are important for patient to continue to improve during their respective rehabilitation process.  However, HEPs should be viewed more as a checklist.  Patients are asked, “did you do your exercises?”. That right there creates a narrative in which the HEP is just an item to cross off the list.

Yes, performing these exercises are essential, but we may need prescribe more than just exercises.  We need to prescribe a sense of ownership, a sense of encouragement, and a sense of self-management.  Perhaps we need to change the terminology a bit, so we can change the narrative as well as the behavior.

HEPs should be referred to as “self-management programs”. This changes the context and the viewpoint of the patient.  Exercises are strategies to be able to participate in activities the patient previously had difficulty with. These strategies are a part of the self-management though process, in which these exercises can be implemented at any time. 

The healthcare professional need to help guide the individual during this idea of self-management, but ultimately the end goal is for the patient to be independent with their own management of their respective impairments and functional limitations.

We want our patients to be self-sufficient and be able to take care of themselves.  We can do this not only by providing them a piece of paper with exercises, but we can provide them with empowerment and confidence that they will be able to successfully execute a self-management program.

Article Written By Eric Trauber, PT, DPT, OCS, CSCS, FAAOMPT