MOVEMENT BEHAVIOR CHANGE: IT MAY TAKE LONGER THAN YOU THINK (RESEARCH SAYS)
MAY 30, 2023 | BY SKULPAN ASAVASOPON, PT, PHD
I used to teach my patients strengthening exercises and even taught them how to walk or move optimally.
But one day, my friend John said, "What's the point of teaching all these exercises if your patient goes back to their old movement patterns when they leave the building?" His comment woke me up and made me realize I needed to target my patient's movement behaviors (aka habits), not just getting patients to do exercises and hale Mary a hope that they follow through with what I teach them in the clinic. Without this consistent bigger picture behavior change concept, I never really took what I started with my patients all the way through to creating new movement habits. This realization has changed my practice indefinitely.
A study that analyzed 12 million observations of peoples' attendance at the gym, showed that it took around 6 months before going to the gym became a habit.
Dr. Anastasia Buyalskaya, first author, said,
“There’s no magic number for habit formation.”
Another study has shown similar variations for other habits:
So, the next time you prescribe exercises for movement behavior change, realize it may take a lot more than doing 3 sets of 10 repetitions over a few weeks.
The often repeated 21 days is not scientific, said Professor Colin Camerer, study co-author, said:
“You may have heard that it takes about 21 days to form a habit, but that estimate was not based on any science.
Our work supports the idea that the speed of habit formation differs according to the behavior in question and a variety of other factors.”
One thing that PTs can leverage is the fact that patients often come in to see them anywhere from 1 to 3 times per week, and sometimes over the course of 6 weeks or even six months - maybe even longer. Coming into therapy over time on a regular basis can, itself, be a mechanism to facilitate movement behavior change. Add the right exercises to that, and you may have a winning combination.
Next time you see your patient, instead of the more conventional strengthening approach, consider strengthening with the purpose of creating a new movement behavior. And realize this means it may take time to build this habit. How long depends on a variety of factors, but no one can say for sure. If anything, you may want to hypothesize a minimum of 6 months to set patient expectations from the get-go.