Date of Completion


Embargo Period



adherence, mental models, physical therapy, home exercise program, adult learning, analogical reasoning

Major Advisor

Dr. Alexandra Bell, Ph.D.

Associate Advisor

Dr. Robin Grenier, Ph.D.

Associate Advisor

Dr. Richard Bohannon, Ph.D.

Field of Study

Adult Learning


Doctor of Philosophy

Open Access

Open Access


Adherence to physical therapy home exercise programs continues to be a multifactorial and poorly understood phenomenon. Prior research suggests that some of the most salient factors affecting adherence reflect individuals’ context-specific prior experiences and perceptions, which strongly influence values and expectations. Collectively known as mental models, these values and expectations guide reasoning and decision-making and show promise in better understanding factors related to adherence.

This qualitative study sought to identify aspects of patients’ mental models that relate to adherence to physical therapy home exercise programs. The researcher employed a basic interpretive qualitative research design using 10 participants (mean age = 50.3 years) beginning outpatient physical therapy for an orthopedic condition. Data were collected data via two face-to-face, semi-structured interviews. Interview One focused on participants’ prior experiences adhering to a regimen unrelated to their current physical therapy experience. Interview Two focused on participants’ current experiences adhering to their physical therapy home exercise program. The researcher completed data analysis using a constant comparative method.

Findings showed that components of participants’ mental models related to their adherence to physical therapy regimens as well as to non-physical therapy regimens. Specific themes highlight the role of realized and anticipated results of the regimen, social supports, and convenience in terms of physical space and time in adherence. This study has direct implications for physical therapists and other health care providers who seek to understand factors that relate to patient adherence. Findings suggest that components of individuals’ mental models may play an important role in adherence behaviors. A better understanding of these factors may enable providers to intervene in ways that promote patient adherence and ultimately improve patient health.