Abstract
Objectives: The objectives of this study were to: 1) explore the feasibility of implementing in-home exercises via a tele-rehabilitation program for Veterans with stroke in Home-Based Primary Care (HBPC) in a single US Department of Veteran’s Affairs Medical Center (VAMC); and 2) assess exercise adherence and progression in Veterans with stroke during the program. Materials and Methods: Study participants completed 3 televideo visits and 5 telephone visits with a physical therapist (PT) over a 3 month period. Participants were instructed in an exercise program and were asked to report adherence with the exercise program and reasons for non-adherence per a standardized questionnaire throughout the program. Televideo visits were conducted using a video link installed on a lap top computer taken to the participant’s home and a desk-top computer at the PT work station. The Late Life Function and Disability Instrument (LLFDI) were used to assess self-report of disability and function at baseline and 3 months. Results: Six male Veterans with a mean age of 61 years enrolled in the study. Four study participants completed the intervention with an average exercise adherence rate of 90%. Self-reported reasons for non-adherence were lack of strength, lack of understanding and lack of needed assistance for the exercises. Increased exercise intensity was demonstrated by all 4 participants. Modest improvements in disability (7%) and function (6%) were reported on the LLFDI. Conclusions: Veterans with stroke were able to actively participate in a tele-rehabilitation program. Study participants reported good exercise adherence and improved disability/function thatwas not statistically significant as well as increased exercise intensity throughout the intervention. Based on these preliminary findings with a small sample, a tele-rehabilitation program aimed at p
Highlights
Substantial numbers of people with stroke experience significant motor disability [1,2,3] which contributes to long-term limitations in activity [4] and participation [5]
Four study participants completed the intervention with an average exercise adherence rate of 90%
Study participants reported good exercise adherence and improved disability/function thatwas not statistically significant as well as increased exercise intensity throughout the intervention. Based on these preliminary findings with a small sample, a tele-rehabilitation program aimed at promoting exercise adherence and progression in Veterans who have had a stroke may be feasible and beneficial
Summary
Substantial numbers of people with stroke experience significant motor disability [1,2,3] which contributes to long-term limitations in activity [4] and participation [5]. These long-term limitations frequently persist after completion of physical rehabilitation. This persistence of ongoing limitations is further complicated by increasingly shorter duration rehabilitation programs [6], making it imperative that people with stroke learn to self-manage their longterm physical limitations. Several reasons for nonadherence have been reported in the literature including; low motivation [17], fatigue [17], not enough time [17], musculoskeletal issues [17], fear of falling while exercising [16],exercise is boring [16], exercise is painful [16], notknowing what exercises to do [16], and doing different exercises other than the ones given by the therapist [16]
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