“Just that four letter word, hope” : stroke survivors’ perspectives of participation in an intensive upper limb exercise program; a qualitative exploration

Journal article

Levy, Tamina, Christie, Lauren J., Killington, Maggie, Laver, Kate, Crotty, Maria and Lannin, Natasha A.. (2022). “Just that four letter word, hope” : stroke survivors’ perspectives of participation in an intensive upper limb exercise program; a qualitative exploration. Physiotherapy Theory and Practice: an international journal of physical therapy. 38(11), pp. 1624-1638. https://doi.org/10.1080/09593985.2021.1875525
AuthorsLevy, Tamina, Christie, Lauren J., Killington, Maggie, Laver, Kate, Crotty, Maria and Lannin, Natasha A.
Abstract

Background
Less than half of stroke survivors will be able to use their arm at 6 months post-stroke. Guidelines recommend the use of intensive upper limb exercise programs to optimize recovery; however, there has been limited research exploring experiences of participation in intensive programs.

Aim
To identify factors influencing adherence to an intensive upper limb exercise program in people with stroke.

Methods
Qualitative design. Semi-structured interviews were conducted with 20 stroke survivors who had participated in an intensive upper limb program. Perspectives of participation, including perceived barriers and enablers to program adherence were explored. Interviews were audio-recorded, transcribed, and imported into NVivo for analysis. Two authors mapped themes to the Capability, Opportunity, Motivation-Behavior (COM-B) behavior change model to identify barriers and enablers to adherence.

Results
Enablers influencing adherence included: 1) routine practice times (Motivation – automatic); 2) accountability to staff (Motivation – reflective); and 3) social support (Opportunity – social). Barriers to adherence included: 1) exercises being too difficult (Capability - physical); 2) reliance on others to help (Capability - physical); and 3) difficulty ‘fitting it in’ (Motivation – reflective).

Conclusion
Findings will inform recommendations for the delivery of intensive upper limb exercise programs to improve adherence and assist services to provide rehabilitation in a manner that enables self-directed practice by stroke survivors.

Keywordsrehabilitation; stroke; adherence; motor training; therapy; physical therapy modalities
Year01 Jan 2022
JournalPhysiotherapy Theory and Practice: an international journal of physical therapy
Journal citation38 (11), pp. 1624-1638
PublisherTaylor & Francis Inc. (US)
ISSN0959-3985
Digital Object Identifier (DOI)https://doi.org/10.1080/09593985.2021.1875525
Web address (URL)https://www.tandfonline.com/doi/full/10.1080/09593985.2021.1875525#abstract
Open accessPublished as non-open access
Research or scholarlyResearch
Page range1624-1638
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online12 Feb 2021
Publication process dates
Accepted13 Dec 2020
Deposited09 Dec 2024
Additional information

© 2021 Taylor & Francis Group, LLC

Funding: This work was supported by the National Health and Medical Research Council under GNT1079542. NAL was supported by a National Heart Foundation Future Leader fellowship (GN102055). Sponsors were not involved in the design, execution, analysis, and interpretation or reporting of the results.

Place of publicationUnited States
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