Pain and Prescribed Exercise Parameters are Associated with Homebased Exercise Adherence Among Community-dwelling Stroke Survivors: A Multicenter Cross-sectional Study

Objective: Adherence to a home-based exercise program (HEP) is important in the achievement of rehabilitation goals among stroke survivors. Earlier studies have measured adherence to HEPs among this population using non-specific outcome measures, which may not be suitable. In addition, the influence of prescribed exercise parameters on adherence remains unclear. This study assessed adherence to HEPs among stroke survivors using stroke-specific measures of adherence to HEP and determined its correlates.
Materials and Methods: This multicenter cross-sectional study involved 125 consenting Nigerian community-dwelling stroke survivors. Data on HEP adherence, prescribed exercise parameters, patients’ attitudes, perceived/encountered barriers to exercise, stroke-related characteristics, and socio-demographics were assessed. Descriptive and inferential statistics were employed. A P value of <0.050 indicated statistical significance.
Results: The mean age of the participants was 60.26 ± 12.11 years. Findings showed that only approximately 35% of the participants were adherent to their HEP. Among the non-adherent group, 22% had no adherence and 43% had low adherence. The results indicated that stroke severity, pain during exercise, a number of prescribed exercises of ≥3, a number of weekly exercise sessions of ≥7, a duration of the exercise of ≥43 min, and exercise intensity of ≥5 on a 0–10 Borg’s rate of perceived exertion scale were found to be related with non-adherence to the HEP (P < 0.050).
Conclusion: Adherence to HEPs among Nigerian community-dwelling stroke survivors is poor. HEP adherence is associated with stroke severity, pain, and the prescribed exercise parameters. This study highlights the need to consider exercise parameters in HEP prescription to enhance patient adherence.