Exercise after stroke: patient adherence and beliefs after discharge from rehabilitation
Exercise after stroke: patient adherence and beliefs after discharge from rehabilitation
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DOI：
10.1080/10749357.2016.1200292
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发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Schmid, Arlene A.
中科院分区：
文献类型：
--
作者：
Miller, Kristine K.;Porter, Rebecca E.;Schmid, Arlene A.
背景资料：大多数人在中风后的前6个月内完成中风后康复，即使运动的益处被认为可以持续6个月以上。物理和职业治疗师提供家庭锻炼计划（HEP），指导患者在康复出院后继续锻炼。不幸的是，人们对成人中风患者的HEP依从率知之甚少。目的：本项目的目的是（1）确定康复后HEP的依从率和不依从的原因，（2）评估HEP依从性与抑郁和疲劳自我报告之间的相互作用，（3）确定患者对中风恢复期间运动益处的信念。设计：这是一项横断面调查研究。在卒中支持小组会议期间制定并分发了一项调查，以确定康复后HEP的依从率、不依从的原因以及患者对运动益处的信念。89%的参与者报告接受了HEP，65.3%的参与者报告至少遵守了部分HEP。确定了不依从的几个原因，包括“做与物理治疗师提供的不同的锻炼”，这是最常见的原因。研究参与者确定了运动在中风康复中的积极作用。结论：患者康复出院后对HEP的依从性不理想。不遵守的原因各不相同。康复治疗师需要能够识别并帮助患者管理HEP依从性的障碍，以促进对残余缺陷的管理。
Background: 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. Objectives: 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.Design: This was a cross-sectional, survey study.Methods: 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.Results: 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. Conclusion: 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.