Promoting patient cooperation with exercise programs: linking research, theory, and practice.

Managing patient-nonadherence with prescribed exercise regimens is not an uncommon task for physical therapists working with individuals with arthritis. Yet little is known about the factors that influence patient adherence with exercise programs or therapist knowledge and use of theoretically based adherence management techniques. Survey research with physical therapists and patients was used to provide a database for further insight into the barriers experienced in implementing exercise programs in clinical practice. In this paper, we suggest that the cooperation with an exercise regimen is mediated by the patient's belief system and requires a therapeutic process of mutual inquiry, problem solving, and negotiation between the therapist and patient. Concepts from research, theory, and practice are integrated into a Process Model for Patient-Practitioner Collaboration for use in clinical practice.