Home exercise considerations
The gym environment may be an intimidating scene for those wanting to get into exercising.
Home Exercise Programs, or HEP, offers the ability to get a foot into the door early.
With specificity and appropriate prescription, HEP’s are used for general wellbeing, rehabilitation and pain management. With entry level exercises that are achievable, to progressions over time to give the best outcome.
HEPs are an individualised series of exercises prescribed to patients to complete in their own home. With a main goal of building muscular strength endurance, tissue tolerance, control and joint mechanics. Strength and Conditioning Coaches coaches can prescribe HEP’s as part of their early stage or long-term rehabilitation process for those who prefer their home comfort.
What are the benefits and limitations of Home Exercise Programs:
The benefits of Home Exercises Programs
- Easy access and low cost.
- Prescribed appropriately for your needs and/or goals.
- Achievable. Programs can be 30 mins, 45 mins or even 20 mins. There is always going to be stimulus.
- Long term improvements on injury and everyday lifestyle.
The limitation of Home Exercise Programs:
- Research suggests that a big concern of home exercise programs is low adherence from patients. This results in potential feelings of confusion, exercises being performed inaccurately, and apprehension to performing exercises when sore or feeling pain.
- Limited equipment access does not provide sufficient variations of exercises that can be loaded properly for the patient and their goals.
- Progressions are stagnant. There are always variations of exercises, but benefits will plateau. Once we reach this level, we must consider using a gym space to progress
We then must consider that HEP’s will not give us the benefits that a gym environment will. Therefore, Strength Coaches will mostly advocate for the use of gym space.
What are considerations for Home Exercise Programs:
- Safety of HEP’s.
- Adherence to HEP’s.
- Exercise dosages and prescription.
- Variability and progression.
Safe and achievable: S&C coaches will select exercises appropriate for the patient. Running through each exercise with demonstrations will set the patient up for completion with absence of S&C coaches.
Patient adherence is something the S&C coaches must consider. A lack of patient adherence can have negative impacts on the results upon the patient’s rehabilitation and progressions, such as inaccurately completing exercises affecting completion and interfering with possible progressions.
Dosaging: Each exercise must be accurately dosed to create a good enough stimulus that results in adaptations. Most commonly prescribed exercises are often through yielding isometrics (holding a position under tension for a period of time), and of course,repetitions with sets.
- Research by Baffour-Awuah B, et al 2023, has suggested that isometric exercises being performed at home for both upper and lower limbs are approximately 2 minutes, in order to create stimulus for adaptation.
- Sets and Repetitions: Simply, 3 sets of 15+ reps is going to be enough to create stimulus. Tolerance to stimulus will build relatively quickly, therefore requiring further program progressions with your coach
We must understand that HEP’s are quite limited in terms of variability and progressive. Whilst variability and progressions are utmost important, as it keeps the program enjoyable, challenging and different. There will become a stage where HEPs no longer provide sufficient tissue adaptations, resulting in the negative effects of detraining. Our only solution here is to move into a gym environment. By then we should establish self-efficacy, and confidence towards a gym environment.
References:
- Baffour-Awuah B, Pearson MJ, Dieberg G, Wiles JD, Smart NA. An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. Clin Hypertens. 2023 Mar 15;29(1):9.
- Anar SO. The effectiveness of home-based exercise programs for low back pain patients. J Phys Ther Sci. 2016 Oct;28(10):2727-2730. doi: 10.1589/jpts.28.2727. Epub 2016 Oct 28
