October 27, 2026
Ask most clinic owners what their home exercise program completion rate is and you get a shrug, or a number that came from a feeling rather than a report. That is not a criticism. Until recently there was no practical way to measure it.
Now there is, and the numbers are worth looking at honestly.
What the research generally shows
Home exercise adherence in outpatient rehabilitation has been studied for decades and the findings are consistently poor. Reviews across musculoskeletal populations commonly land somewhere between a third and a half of patients doing what was prescribed, with wide variation depending on how adherence was defined and who was asked.
That range is worth sitting with. If half your patients are not completing their program, half your outcomes are being produced by something other than the plan you built.
The measurement problem underneath it
Part of why the numbers are bad is that the measurement was bad.
Self-report inflates. Patients tell you what they think you want to hear, and they are not lying so much as remembering generously. Recall over four weeks is unreliable for anyone.
Paper logs get filled in the morning of the visit. Everyone in this profession knows it.
And most definitions of adherence are binary when the reality is graded. A patient who does three of five prescribed sessions a week is not adherent or non-adherent. They are at sixty percent, and that is a different clinical conversation.
Digital tracking changed what is measurable, which is the actual contribution of remote therapeutic monitoring. Not the reminders. The visibility.
What we measure
Adherence at MovementRx runs around 78 percent, against a commonly cited national figure closer to 30 percent for remote monitoring programs generally. In a retrospective analysis of 2,230 patients from 2023, RTM patients showed 40 percent higher home exercise adherence than non-RTM patients at the same clinic, controlling for baseline differences.
Those figures are preliminary and have not been peer reviewed. They come from one clinic system, which is a real limitation, and they are part of what the NIH Direct to Phase II SBIR application we submitted proposes to test properly across five geographically diverse sites.
I would rather tell you that plainly than present internal numbers as settled science.
Why the gap is not about the app
Here is the part that matters for anyone comparing platforms.
The mechanism is not the reminder. Patients ignore push notifications the way they ignore every other notification. The mechanism is that a clinician sees the drop and calls.
That is why a platform with a beautiful patient app and no monitoring workflow produces mediocre adherence, and why a mediocre app with a licensed person watching the data produces good adherence. The software makes the behaviour visible. A human acting on what they see is what changes it.
If a vendor shows you an adherence number, ask what the monitoring workflow behind it was. The number is meaningless without it.
What good looks like, practically
Set a threshold rather than tracking an average. An average hides the patients who need you. Decide what counts as at risk, for example fewer than three logged sessions in seven days, and act on that list.
Measure days of engagement, not completed sets. Days is what the device supply codes count anyway (see the RTM CPT codes), and it is the more honest measure of whether the program is part of their life.
Look at week two. Adherence curves fall off fastest between the first and third week, before habit forms. A patient who is still logging at day twenty-one usually finishes the episode.
And separate the two failure modes. A patient who is not doing the program because it hurts is a clinical problem. A patient who is not doing it because they forgot is an engagement problem. They need different responses and most programs treat them the same.
What this means for your clinic
You cannot improve what you are not measuring, and self-report is not measurement. Pick one cohort and track actual engagement days for a month before you make any decisions about platforms.
Then decide who looks at that data and what they do about it, because that decision, not the software, is what will move your number.
If you want to see what engagement tracking looks like against your own patient population, request a demo. The RTM calculator will show you the revenue side if that is the part you need to justify first.