To determine whether to advance a patient's home exercise program (HEP), what should guide the decision?

• A. The clinician's intuition
• B. The patient's response
• C. A fixed 2-week timeline
• D. A predetermined progression regardless of symptoms

Answer: (B)

Progression of a home exercise program should be guided by how the patient responds to the current routine. Monitor pain levels, tolerance to load, range of motion, strength, functional performance, and ability to carry out daily or sport tasks. If the patient tolerates the current exercises without worsening symptoms and shows signs of improvement, you can safely increase the challenge. If pain increases, fatigue is excessive, or function declines, pause or modify the progression.

Relying on the clinician’s intuition alone isn’t ideal because progression needs to reflect real-time patient tolerance. A fixed timeline ignores individual recovery rates, and a predetermined progression regardless of symptoms risks overloading or under-stimulating the patient.