Adherence to a Home-Based Exercise Program for Individuals After Stroke

Background: Although aerobic training (AT) and resistance training (RT) have been shown to improve functional abilities in patients post stroke, few patients participate, with many doing so for only a short duration. Purpose: To retrospectively identify factors that affect adherence to a home-based exercise program adapted for stroke patients in a cardiac rehabilitation program during and after program completion. Methods: Fourteen participants (age 63 +/- 3 years, 37 +/- 34 months post stroke) attended the rehabilitation center on a weekly (24 weeks) and then monthly (2 months) basis. Patients were required to complete 4 AT and 1 to 2 RT sessions away from the center each week. A 16-item survey exploring adherence to home-based workouts was administered. Results: Seven patients were currently participating (mean time in program, 19.4 +/- 8 weeks) and 7 had graduated (mean of 32.8 +/- 28 weeks post graduation) from the program. Current participants had higher adherence than graduated participants to AT (100% vs 76%; P < .01) and RT (100% vs 55%; P < .01). The most common factors motivating participants were to improve overall health, improve functional abilities, and enhance confidence and to reduce musculoskeletal issues. The most common factors preventing workouts were lack of motivation, musculoskeletal issues, and fatigue. There was a negative correlation between age and adherence to AT in the graduated group. Conclusion: Adherence to home-based exercise is superior during participation in an organized group program, with decline after graduation.