If seven years is anything to go by, it’s the fact that seeing 6 patients a day, 5 days a week, 40 weeks a year means I would have had 8400 exercise programs to learn something from.
That means I practically eat, sleep and dream of exercise programs. If exercise were a drug, I would be your shady crack dealer, handing them out to unsuspecting ladies with walkers left right and centre.
But how do we make our exercises more addictive?
Well, here are 7 great ways to make that happen.
#1 State the Goal in a fun way
Use emotive, evocative language to set the goal. So instead of writing, “To stand on one leg and balance”, say “To be able to kick a ball in the dark without falling!” or “To beat my sister at getting to the park”. The more unusual this is, the more it will stick
#2 Get the patient to make stuff up
The best exercise programs are the ones that the patient has some say in. This is because of patients who can come up with part of the exercise will:
be more likely to learn it quickly
be more likely to do it
be more likely to perform it correctly
A good place to start is to ask, “What do you think you could do as an exercise so we can achieve this sort of movement?”
#3 Make it intense
The exercises need to be intense for it to have the most benefit.
Clearly, the more you give the body to work with, the more it will try to meet the workload.
Increase the repetitions to more than 3 x 10. Try 80 reps. Try 105 reps. Make it fast for fast twitch adaptation or improvements in power. The more systems we can involve (e.g. cardiovascular, cognitive, sensorimotor, perceptive), the more we can drive multi faceted learning and progress.
#4 Don’t be boring
Your exercise program should have some novelty factor into it. Whether it’s as simple as giving it a funky name, like “The Banana Split” or “Tah Dah!”, giving your names funny and memorable names will make it easier to associate an image or evoke a feeling to the exercise that intrinsically make it more motivating.
Give your exercises some texture and interest. Vary the speed. Vary the range. Vary anything you can to make it more realistic and less robotic. The cerebellum – the cortex’s wingman – will pay more attention that way.
#5 Agree on a reasonable reward
While for some people, the reward of completing the exercise program is enough (foolishly, this is what we therapists always tell ourselves), we should bear in mind that reward is extremely powerful as a subconscious motivator to exercise intent. The patient and therapist should agree beforehand on what that reward is. Family input is great for this.
This works especially well for upper limb type exercises that involve reaching, grasping and then eating multiple M&Ms.
#6 Find that Internal Measure
Internal measure is the way in which the patient can sense that they are doing their exercises accurately and effectively. This is a CRUCIAL element that is often missed, because not enough time is spent on the patient’s experience of the movement, or therapists talk too much and do not allow the patient’s other senses to take over.
If this is not done, patients will no doubt come back to you in the next session with a completely different exercise.
#7 Progress, Progress, Progress
From the first exercise program, I find that giving patients an idea of how the exercise can be progressed allows patients to immerse themselves more fully into the program, especially if they can see that they can progress the exercises themselves. Self-progression means less boredom, more benefit, more quickly.
And pretty soon, you will find that the best exercise programs are like perishable goods – fresh and juicy, but with a short shelf life.
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