OBJECTIVE: To evaluate the effects of (i) face-to-face verbal instructions, (ii) illustrated brochures, (iii) audiotapes, and (iv) videotapes on correctness of exercise performance and home exercise adherence. DESIGN: Systematic search and critical evaluation of the literature. METHOD: A comprehensive systematic literature search using electronic databases and crossreferencing yielded five studies that satisfied all the following criteria: (i) investigation on the effectiveness of home exercise instruction via verbal instruction, brochure, audiotape, or videotape; (ii) prospective experiments; and (iii) quantitative outcomes for correctness of exercise performance or exercise adherence. In addition, instruction methods in adults who were prescribed exercises in hospital setting that need to be continued at home were eligible for inclusion if they met the other criteria. Excluded were papers not written in English, retrospective studies or studies that evaluated the performance of passive exercises, relaxation, or movement skills in sport. RESULTS: The provision of verbal exercise instructions together with illustrated handouts led to greater correctness of exercise performance and home exercise adherence than either method in isolation. In comparison to illustrated brochures, videotaped instructions were shown to enhance exercise accuracy and adherence. CONCLUSION: The weight of the evidence suggests that videotaped instructions provide the most effective modality for optimising correctness of exercise performance as well as adherence. Face-to-face verbal instructions combined with an illustrated brochure enhanced correctness of exercise performance and home exercise adherence in people with back pain. Videotaped instructions in addition to verbal and written instructions were effective for older adults who had undergone hip arthroplasty. Although there is modest support for providing videotaped instructions, it is recommended that physiotherapists also consider using verbal instructions and illustrated brochures with optimal readability when prescribing home exercises for older people.

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