Firing up the rehabilitation: a holistic approach emphasising complex practice environments to change exercise behaviour

Rehabilitation, covering areas such as injury, cardiac, pulmonary and mental health, is evolving toward patient-centred care.1 However, motivating patients to maintain exercise habits remains challenging,2 with a disconnect between programme design, behavioural change theories and professionals’ ability to apply behavioural change techniques.3 The aim of this editorial is to emphasise the need for rehabilitation programmes that move beyond traditional treatments by integrating holistic, patient-centred approaches. This includes fostering emotional, psychological and social growth alongside physical recovery. Social-structural and interpersonal barriers hinder adherence to exercise maintenance. A lack of psychological and social support significantly impacts adherence to exercise interventions, both during and after rehabilitation, which is essential for initiating and sustaining health-related behaviours.2 4 5 Habitual behaviours, deeply ingrained and automatic, inhibit new interventions, highlighting the need for targeted, context-specific strategies.4 Enhancing the expertise of rehabilitation professionals to use theoretical models promoting holistic approaches can help break down entrenched beliefs and foster new cultural understandings about rehabilitation.6 Compliance has been an issue in physiotherapy since the 1970s.7 The role of rehabilitation in patients’ lives should not be reduced to just ‘medicine’. Such programmes ought to integrate into a patient’s life, seeking not just health (mostly physical)8 results but also personal growth, emotional enhancement and positive social connections. The motivation for individuals to adhere to a rehabilitation programme, ensuring exercise maintenance, should not be dictated only by fear of health deterioration, physical performance or other external factors. These external motivations …