Adherence to home-based neuro-rehabilitation exercise program in stroke survivors

Background:Post discharge, Home-based exercise program (HEP), prescribed by physiotherapist is an integral part, to plan effective stroke rehabilitation, with the intended goal of maintaining functional motor performance and enhancing functional progress.Earlier studies have shown that many factors attribute to adherence and barriers for structured group based exercise program. Objective: This study was designed to identify the factors in stroke subjects, which may influence the adherence and barriers to individually tailored HEP post-discharge, in stroke subjects.Method: An analytical cross-sectional study, with non-random sampling, consisting of first onset stroke subjects who had received acute stroke rehabilitation from tertiary care hospitals. Post-discharge, seventy-four participants were followed up and their responses related to adherence and barriers to the prescribed HEP by administering a self-reported adherence to home exercise questionnaire. Results: 63.5% were adherent and 36.5% were non-adherent to HEP, among 74 subjects. The adherent group had performed exercises for at least 5-6 times in a week, for 31-45 minutes each day. Intrinsic factors related to self-efficacy and perceived level of anticipated recovery had found an association with adherent and non-adherent groups.The most common barriers for adherence to HEP were fear of fall or injury and fatigue for both adherent and non-adherent subjects. Conclusion: This present study helped to put an insight, onto sociodemographic and intrinsic factors, with the level of adherence and to identify the barriers for adherence to individually tailored HEP.