Abstract
Introduction
Upper limb recovery after stroke depends on participating in an individualised task-specific exercise programme. However, older adults with stroke find it challenging to maintain an optimal level of physical activity due to personal and environmental factors. The aim of this study was to explore the perceptions of patients and stroke therapists on home-based resistance exercises for upper limbs.
Methods
A qualitative study of semi-structured virtual and in-person interviews was conducted between January and March 2023 in England. Participants were 11 older adults (>65 years) with chronic stroke (>1 year after a stroke and moderate to severe disabilities) and rehabilitation therapists (n=20). The group were asked about perceived personal and environmental barriers and facilitators as well as expectations around resistance exercises in relation to their neurorehabilitation programmes. Interview sessions were audio recorded for transcription and thematic data analysis. The study was approved by the ethics committee at Sheffield Hallam University.
Results
Both groups mentioned that the main barrier to doing upper-limbs exercises is weaknesses in the paretic arm affecting their grip that consequently impacts on their adherence to a home exercise programme and motivation. Patients also reported safety concerns such as dropping equipment and being dependent on a carer to undertake regular exercise. Stroke suvivors preferred a program that activates the paretic arm and is relevant to their daily functional activities. They asked for simple exercise instructions and demonstrations through visual aids and video materials. Patients added that they need regular feedback for adjusting their exercise dose, monitoring progress over time, and ongoing encouragement.
Conclusions
Our study showed that designing home-based resistance exercises for upper limb for older adults stroke survivors should be individualised, functionally orientated, and motivational.