Why Every Exercise Needs a Checklist

Introduction:

You just finished your session with your patient, then what? Do you confirm their next appointment? Answer any questions they have? Re-test specific measurements? Sure, these are all valuable tasks to perform. But, most physical therapists miss out on a simple yet powerful tool — providing an exercise checklist. This article will discuss how a simple checklist can elevate your physical therapy care and provide three primary benefits to your patients.

Article Key Points:

• Improved Exercise Technique
• Higher Coaching Standards
• Enjoyable Patient Experience
• Exercise Checklist Example

If you're a visual learner, click the video below to watch the same concepts discussed in this article.

Improved Exercise Technique

When your patient is at home practicing their PT exercises, how do you ensure they perform them with the correct technique? Unfortunately, unless you have a virtual session, you truly cannot control what their form looks like. But, with a checklist, you can!

Checklists will provide them with the step by step instructions for success every time they perform the movement. When their technique doesn't feel right, all they need to do is go through their checklist steps to correct the compensation. As a result, you will see improvements in technique, yielding better patient outcomes. Using this as strategy to maintain proper technique is a critical step to not only getting your patient out of pain, but keeping them out of pain! Here are some key things to include on your checklist:

• Proper setup
• Pertinent coaching cues
• Where they should feel the movement
• Where they should not feel the movement
• Sets/reps

Higher Coaching Standards

The practical byproduct of an exercise checklist is the higher coaching standards it consciously or subconsciously creates. As a physical therapist, it shifts your perspective from the movement expert mindset and into the thought process the movement novice. As a result, it challenges you to think and provide the patient with understandable, direct, and high-level coaching cues to provide movement comprehension. When this occurs, your patient doesn't repeat the exercise, they learn how and the why.

For example, we all know that a posterior pelvic tilt can be a challenging definition and movement for your patient to comprehend and perform. Another layer of complexity is added when they practice it individually at home. 

So, if you only use the term "posterior pelvic tilt" in the clinic and provide no checklist, then they will go home confused and neglect the value of the exercise. The unfortunate outcome is an incorrect movement technique, frustration, not performing your HEP, and quitting. Does this scenario sound familiar?

Conversely, when you utilize an exercise checklist to raise your coaching standards — you'll have success every time. For example, on their exercise checklist, replace the term "pelvic tilt" with "belt buckle." Next, replace "posterior" with "towards your chin." So, this step on their exercise checklist now says, "Tilt your belt buckle towards your chin."

By changing your language, the movement novice has the strategies and comprehension to move like a movement expert. Continue to raise your standards for every exercise with every patient.

Patient Satisfaction

Are you looking to increase your patient satisfaction rate and buy-in simultaneously? Then, the exercise checklist is your solution! But, let's be honest, it's more than a checklist. It's a strategy that shows you genuinely care, want them to succeed, and want to positively impact their life. Following this principle in any business will yield a positive customer experience. But, do this in physical therapy, and you change from a physical therapist to their physical therapist!

Exercise Checklist Example: Bridge

• Place band around knees and lay flat with your knees bent
• Press through mid-foot heel into the group
• Clown shoes** 
• Maintain the band pressure - don't push in or out
• Should feel glutes/hamstrings prior to movement
• Maintain glutes/hamstrings while pressing hips to the ceiling
• Aim to have hips in a straight line with shoulders
• 3-second hold
• Maintain glues/hamstrings on the descent
• Tap bottom and repeat x 12
• Shouldn't feel low back

**Clown shoes are a coaching cue to improve hamstring recruitment. I like to ask people if they're familiar with clown shoes. Most people say yes and they understand how big they are. So, I tell them to imagine they have clown shoes on and to draw the heel back in the shoe to turn on the hamstrings (isometric knee flexion)