The effect of brochure use versus therapist teaching on patients performing therapeutic exercise and on changes in impairment status

Department of Orthopedic Physiotherapy, Orthopedic Hospital Speising, Vienna, Austria.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate whether the mode of teaching exercises (use of brochures versus therapist teaching) affects whether patients correctly perform the exercises and whether it affects changes in impairment. SUBJECTS: Eighty-seven patients (33 women, 54 men) with neck pain and low back pain were examined. The average age was 48 years (SD = 12.7, range = 21-67). METHODS: Two groups of patients were analyzed. The supervised (physical therapist-instructed) group (n = 47) exercised under the supervision of a physical therapist, whereas the brochure group (n = 40) received their instructions only from one of three brochures. A rating scale was used to assess the correctness of exercise performance. Muscle status was registered using a standardized procedure for determination of muscle force and length. Pain severity was determined by means of a visual analogue scale. RESULTS: On the rating scale evaluating the correctness of exercise performance at follow-up, the patients in the supervised group performed better than the patients in the brochure group. In addition, there was a strong correlation between the quality of exercise performance and decrease in pain. CONCLUSION AND DISCUSSION: Exercises learned only from a brochure without being monitored by a physical therapist were done properly by only about half of the patients and appeared to result in fewer improvements in impairments.

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