Adherence to home exercises and rehabilitation (ADHERE) after stroke in low-to-middle-income countries: A randomized controlled trial

Amreen Mahmood, Pradeepa Nayak, Coralie English, Anagha Deshmukh, U. Shashikiran, N. Manikandan, John M. Solomon

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10 Citations (Scopus)


BACKGROUND: Adherence to prescribed exercises is essential for home-based programs to be effective, but evidence for strategies to enhance exercise adherence in people with stroke is lacking.

OBJECTIVES: To determine the effect of adherence strategies on the proportion of people with stroke who adhere to prescribed home-based exercises and their level of adherence at 6 and 12 weeks of intervention. Our secondary objective was to determine the effect of the combined intervention on mobility and quality of life post-stroke.

METHODS: We conducted an RCT among people with stroke (Exp = 27, Con = 25) living in semi-urban India. Both groups received standard hospital care and a home exercise program. The experimental group also received adherence strategies delivered over five sessions. Adherence was measured using the Stroke-Specific Measure of Adherence to Home-based Exercises (SS-MAHE) , mobility using Mobility Disability Scale, and quality of life using the Stroke Impact Scale.

RESULTS: The experimental group had better exercise adherence compared to the control group both at six (mean difference [MD] 45, 95% CI 40, 64, p < .001) and 12 weeks (MD 51, 95% CI 39, 63, p < .001). The experimental group also had better mobility at 12 weeks (median (IQR), experimental 42 (57), median (IQR), control 95 (50), p = .002). There was no difference in the quality of life scores between groups at six or 12 weeks.

CONCLUSION: The adherence strategies were effective in improving exercise adherence and mobility post-stroke but did not improve quality of life.


Original languageEnglish
Pages (from-to)438-448
Number of pages11
JournalTopics in Stroke Rehabilitation
Issue number6
Publication statusPublished - 2022

All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Community and Home Care
  • Clinical Neurology


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