Factors influencing adherence to a home-based strength-training programme for young people with cerebral palsy

Abstract

Background and purpose There is evidence that strength training can be beneficial for young people with cerebral palsy. To successfully implement a strength-training programme the physiotherapist should consider factors that can affect adherence. This study explored factors that influence adherence to a home-based strength-training programme for young people with cerebral palsy. Methods Eleven young people with cerebral palsy and their parents were interviewed after completing a six-week home-based strength-training programme that led to improved lower limb strength. The in-depth interviews explored issues related to adherence. Transcripts of the interviews were coded independently and themes on adherence to strength training were developed. Results Two themes emerged categorised as: environmental factors and personal factors. Environmental factors optimising adherence included emotional and physical support from family members, provision of equipment, provision of an exercise logbook, having a programme with a small number of exercises, and the role of the physiotherapist as exercise coach. The main personal factors influencing adherence were motivation, autonomy, and the effort involved in completing the exercises, while some participants commented on health issues and time management. Conclusions The personal and environmental factors that influenced adherence to a simple yet effective strength-training programme for young people with cerebral palsy can be influenced and facilitated by the physiotherapist.