title: Exercise after Stroke: Patient Adherence and Beliefs after Discharge from Rehabilitation.
abstract: Most people complete post-stroke rehabilitation within the first 6 months after stroke even though benefits from exercise are believed to persist well beyond 6 months. Physical and Occupational therapists provide home exercise programs (HEP) to instruct patients on exercises to continue after discharge from rehabilitation. Unfortunately, there is little known about HEP adherence rates in adults with stroke.
  
  
  
  The objectives of this project were to (1) determine the adherence rate with post-rehabilitation HEP and reasons for non-adherence, (2) assess for interactions between HEP adherence and self-report of depression and fatigue, and (3) determine patient beliefs about the benefit of exercise during stroke recovery.
  
  
  
  This was a cross-sectional, survey study.
  
  
  
  A survey was developed and distributed during stroke support group meetings to determine adherence rates with post rehabilitation HEP, reasons for non-adherence, and patient beliefs about the benefit of exercise.
  
  
  
  Eighty-nine percent of participants reported receiving a HEP and 65.3% of those reported being adherent with at least part of the HEP. Several reasons for non-adherence were identified, including 'doing different exercises than the ones given by the physical therapist', as the most frequently given reason. Study participants identified positive roles of exercise in their recovery from stroke.
  
  
  
  Patient adherence with HEP after discharge from rehabilitation is less than ideal. Reasons for non-adherence are varied. Rehabilitation therapists need to be able to identify and help patients manage barriers to HEP adherence to promote management of residual deficits.
authors.affiliation: a Indiana University , School of Health and Rehabilitation Sciences, Department of Physical Therapy , 1140 West Michigan Street, CF 326F, Indianapolis , IN , USA.
authors.forename: Kristine K
authors.initials: KK
authors.lastname: Miller
authors.affiliation: a Indiana University , School of Health and Rehabilitation Sciences, Department of Physical Therapy , 1140 West Michigan Street, CF 326F, Indianapolis , IN , USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Porter
authors.affiliation: b Indiana University Health , Methodist Hospital, Occupational Therapy Department , Indianapolis , IN , USA.
authors.forename: Erin
authors.initials: E
authors.lastname: DeBaun-Sprague
authors.affiliation: c Clemson University , College of Health, Education, and Human Development, Recreational Therapy Program , Clemson , SC , USA.
authors.forename: Marieke
authors.initials: M
authors.lastname: Van Puymbroeck
authors.affiliation: d Colorado State University , Department of Occupational Therapy , Fort Collins , CO , USA.
authors.forename: Arlene A
authors.initials: AA
authors.lastname: Schmid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003469:Culture; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010351:Patient Discharge / Q000706:statistics & numerical data; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology*; D000071939:Stroke Rehabilitation
keywords: Exercise adherence; Home exercise programs; Post-rehabilitation exercise; Stroke