title: Adherence to use of a home-based exercise DVD in people with Huntington disease: participants' perspectives.
abstract: BACKGROUND
  Individualized exercise instruction on a regular basis may be desirable for people with Huntington disease (HD). Sustained interventions, however, may not be the most feasible for lifelong disease management. It is critical, therefore, for physical therapists to find ways to facilitate engagement in independent exercise programs. The capabilities of DVD technology can make the DVD a useful format to facilitate engagement for people with HD who have motivational and cognitive problems.
  
  
  OBJECTIVE
  The purpose of this study was to explore how people with HD used a home-based exercise DVD and how it was perceived by the participants and their caregivers.
  
  
  METHODS
  An exploratory, mixed-method design was used in this study.
  
  
  METHODS
  Fifteen participants with HD were provided with an exercise DVD, developed by the authors, to support their engagement in a home-based exercise program. Exercise diaries were used to record adherence rates. Semistructured interviews were conducted to explore what factors affected the usability of the DVD. Conversations were audio recorded and fully transcribed. Content analysis approach was used to analyze the interviews.
  
  
  RESULTS
  Most of the participants (11/15, 73.3%) adhered well to the use of the DVD. Participants felt that the exercises were suitable. Commitment of the caregiver as a key to the success of the program was the main theme that emerged from the data. Participants identified barriers and facilitators that affected adherence to using the exercise DVD and described management strategies that helped promote adherence to the exercise program.
  
  
  CONCLUSIONS
  The DVD was perceived to be suitable and supportive. The DVD could be appropriate for use in supporting people with HD to engage in exercise at home, either outside of therapy sessions or upon completion of a therapy program.
authors.affiliation: Department of Physiotherapy and Research Centre of Clinical Kinaesiology, School of Healthcare Studies, Cardiff University, Cardiff, South Glamorgan, United Kingdom.
authors.forename: Hanan
authors.initials: H
authors.lastname: Khalil
authors.forename: Lori
authors.initials: L
authors.lastname: Quinn
authors.forename: Robert
authors.initials: R
authors.lastname: van Deursen
authors.forename: Richard
authors.initials: R
authors.lastname: Martin
authors.forename: Anne
authors.initials: A
authors.lastname: Rosser
authors.forename: Monica
authors.initials: M
authors.lastname: Busse
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006699:Home Care Services; D006801:Humans; D006816:Huntington Disease / Q000523:psychology* / Q000534:rehabilitation*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D020377:Self Efficacy; D016896:Treatment Outcome; D014742:Videodisc Recording