Exercise on prescription schemes for stroke patients post-discharge from physiotherapy

Abstract

Purpose. ‘Exercise on prescription’ (EoP) schemes run by fitness instructors in leisure centres in the UK have potential to promote continued rehabilitation and activity engagement post-discharge from stroke physiotherapy. This study explores the views of physiotherapists, stroke patients and fitness instructors about the appropriateness and acceptability of EoP schemes for stroke patients post-discharge from physiotherapy.Method. This qualitative study collected data from stroke patients referred to EoP, fitness instructors and referring physiotherapists (n = 30). Data were transcribed and analysed thematically. Exploration of key themes within and between groups was made.Results. Referral to EoP appears to alleviate some of the distress that patients and physiotherapists experience at physiotherapy discharge and provide an opportunity for physiotherapists to wean patients from physiotherapy. However, concerns about risks to patients because of fitness instructors' low levels of knowledge about stroke and the limited monitoring of exercisers were identified. Physiotherapists are likely to refer only the most able patients post-stroke to EoP.Conclusions. The study indicates that, in the light of limited health resources, EoP schemes have potential benefit for people post-discharge from physiotherapy. However, safety needs and the concerns of stroke survivors must be considered in EoP scheme development and management if they are to successfully help more people post-stroke maintain healthy levels of activity and fitness.