When adherence breaks on language
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A patient nods during the consult. She repeats the name of the exercise, smiles, leaves. Two weeks later there is barely any progress. Not unwillingness, not low motivation: she only half understood the printout at home.
How often this happens
Almost 2.5 million people in the Netherlands do not have Dutch as their first language (Pharos, 2025). A 2022 Berenschot study among 466 healthcare and welfare professionals shows what that means in practice: 15% (very) often run into a language barrier with patients who do not share their language. What happens next is the more telling part. In the situations where professionals themselves judge that an interpreter is needed, 72% rarely or never bring one in.
Patients usually manage fine in the consult itself: describing the complaint, yes, no, basic exchange. It breaks down at the next step: the instructions for home exercises. Sets, reps, breathing, contraindications, what to do when it hurts. That's where a program stands or falls, and that's where language becomes a barrier.
What it costs
A misunderstanding doesn't read like a misunderstanding. It reads like "patient isn't doing the exercises." That conclusion costs you consults where you re-explain what you'd already explained, a program you simplify because you assume it was too hard, or in the worst case a patient who drops out.
Adherence to home exercise is shaky to begin with. A 2024 overview of systematic reviews estimates that non-adherence to unsupervised home programs can run as high as 70% (Ley & Putz, 2024). Add a language barrier and it drops further. A systematic review focused on physiotherapy asked therapists to assess their own quality of care. In their judgement, language barriers limited history-taking, the use of standardised tests and building a rapport with the patient (Neipert et al., 2024). In musculoskeletal care, having a language preference other than the clinician's is consistently associated with worse postoperative outcomes and a harder recovery (Garcia-Lopez et al., 2025).
How practices solve it today
Three routes, all three with gaps.
Telephone interpreter. Works in the consult, but the patient goes home without one. The written part (exactly what she needs over the next week) stays in Dutch.
Family member as interpreter. Cheap and direct, but problematic. Privacy isn't covered, children sometimes translate for parents in situations where that isn't appropriate, and at home there's no one around to repeat anything.
Google Translate. Accessible, but with no clinical context. "Bridge" becomes "brug" instead of "glute bridge". "Hold for 10 seconds" comes out grammatically correct but conceptually fuzzy. And you have no idea what arrives on the other side: you can't check a translation in a language you don't read.
What AI translation in the exercise program actually solves
A translation feature that lives inside your exercise tool fills the gap the other three leave open:
- The translation travels with the program. The patient opens the schedule, picks her language, sees the instructions in Polish, Turkish, Arabic, English, whatever she speaks.
- Terms are already standardised. If you work with a fixed exercise library, names and execution descriptions are translated consistently rather than ad hoc per consult.
- The physio keeps working in Dutch. No extra entry time, no building a bilingual program by hand.
For the patient, one thing changes: at home she reads what was discussed in the consult, in a language she actually understands.
What it doesn't solve
Translation doesn't replace the consult. The relationship, the physical examination, the explanations with hands and examples: that still happens in the treatment room, in whatever language you find together.
Medical terminology remains a risk. Models have improved, but don't expect specialised jargon to come through flawlessly every time. A term that lands precisely in Dutch can carry slightly different connotations elsewhere. For critical instructions (contraindications, red flags), verify in the consult that the patient has the meaning, not just the translation.
Translation also doesn't fix cultural factors. How a patient views pain, movement, exercising, the authority of the clinician: those are different conversations.
What this means for your practice
If you regularly see patients who don't share your language and adherence in that group lags behind, the question isn't whether you can do something. The question is which gaps you close and which you accept. Translated written instructions close the part between the consult and the next appointment, exactly where home-exercise adherence falls apart.
Where Kinmo fits
Kinmo uses AI for one task: translating exercise instructions. The therapist builds the program in Dutch; the patient opens it in her own native language with a single click. The rest of the tool works without AI, because AI isn't needed there.
Not translation as a marketing checkbox, but as a way of closing a barrier that's visible every day in a city physiotherapy practice.
Sources
- Ley, C., & Putz, P. (2024). Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis. Systematic Reviews, 13, 137. doi:10.1186/s13643-024-02538-9
- Neipert, A., Russo, K., Ortt, S., et al. (2024). Impacts of language barriers on perceived quality of care in physical therapy: a systematic review. Bulletin of Faculty of Physical Therapy. doi:10.1186/s43161-024-00216-4
- Berenschot (2022). Tolken in de zorg: een overzicht van huidige inzet, financiering en knelpunten (n=466). Commissioned by the Dutch Ministry of Health, Welfare and Sport.
- Pharos (2025). Generieke richtlijn Omgaan met taalbarrières in de zorg en het sociaal domein. pharos.nl
- Garcia-Lopez, E., O'Marr, J., Gottlieb, R., Miclau, K.R. & Pandya, N. (2025). Language Barriers in the Delivery of Musculoskeletal Care and Future Directions. Current Reviews in Musculoskeletal Medicine, 18, 559-567. doi:10.1007/s12178-025-09986-3