Enhancing Motivation and Adherence to Exercise Rehabilitation in Stroke Survivors

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This project aims to establish the feasibility of integrating contemporary exercise motivation principles into rehabilitation programmes for stroke survivors. Advances in medicine and surgery have led to improved chances of surviving stroke, but this progress means increasing pressure on rehabilitation services to support recovery of patients. For patients to fully benefit from rehabilitation programmes, they must adhere to their prescribed programme. Adhering to treatment significantly influences patient outcomes. However, adherence to physical exercise rehabilitation has been shown to be especially challenging in patients with a stroke, notably when they move from supervised to independent rehabilitation. Health professionals are aware of the need to motivate patients during their stroke rehabilitation, yet there is limited guidance on effective motivation strategies or how to implement them. Contemporary models of human motivation integrate both cognitive and affective motivational processes to help understand why people persist or disengage from behaviour. Applying these contemporary concepts of motivation could potentially enhance adherence to rehabilitation programmes. This project therefore aims to connect current rehabilitation delivery and contemporary understanding of motivation to facilitate adherence. The project will develop and assess the feasibility of an intervention, based on selected motivational principles, that can be translated into strategies for patients, carers, and/or clinicians. This research will develop an understanding of motivation and adherence to physical rehabilitation to alleviate the individual, societal and financial costs associated with poor adherence. It will further provide the basis for clinicians and patients to implement motivational strategies and test their effectiveness. Finally, the patients and clinicians involved in the project will be able to guide future research on the applicability of motivational principles in the context of stroke rehabilitation and aid theoretical development. The research has the potential to stimulate training and education opportunities for rehabilitation staff.