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Phys Ther. 2019 Jan 1;99(1):74-85. doi: 10.1093/ptj/pzy126.

Adherence to a Long-Term Physical Activity and Exercise Program After Stroke Applied in a Randomized Controlled Trial.

Author information

1
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, P.O. Box 8905, N-7491 Trondheim, Norway; and Stroke Unit, Department of Internal Medicine, Trondheim University Hospital, Trondheim, Norway.
2
Department of Physiotherapy, Oslo; Akershus University College, Oslo, Norway; and Sunnaas Rehabilitation Hospital, HF, Nesoddtangen, Norway.
3
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology.
4
Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology.
5
Department of Internal Medicine, Vestre Viken Hospital Trust, Baerum Hospital, Oslo, Norway.
6
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology; and Stroke Unit, Department of Internal Medicine, Trondheim University Hospital.
7
Unit for Physiotherapy Services, the Municipality of Baerum, Baerum, Norway.
8
Unit for Physiotherapy Services, the Municipality of Trondheim, Trondheim, Norway.
9
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology.

Abstract

Background:

Persistent physical activity is important to maintain motor function across all stages after stroke.

Objective:

The objective of this study was to investigate adherence to an 18-month physical activity and exercise program.

Design:

The design was a prospective, longitudinal study including participants who had had a stroke randomly allocated to the intervention arm of a randomized controlled trial.

Methods:

The intervention consisted of individualized monthly coaching by a physical therapist who motivated participants to adhere to 30 minutes of daily physical activity and 45 minutes of weekly exercise over an 18-month period. The primary outcome was the combination of participants' self-reported training diaries and adherence, as reported by the physical therapists. Mixed-effect models were used to analyze change in adherence over time. Intensity levels, measured by the Borg scale, were a secondary outcome.

Results:

In total, 186 informed, consenting participants who had had mild-to-moderate stroke were included 3 months after stroke onset. Mean age was 71.7 years (SD = 11.9). Thirty-four (18.3%) participants withdrew and 9 (4.8%) died during follow-up. Adherence to physical activity and exercise each month ranged from 51.2% to 73.1%, and from 63.5% to 79.7%, respectively. Adherence to physical activity increased by 2.6% per month (odds ratio = 1.026, 95% CI = 1.014-1.037). Most of the exercise was performed at moderate-to-high intensity levels, ranging from scores of 12 to 16 on the Borg scale, with an increase of 0.018 points each month (95% CI = 0.011-0.024).

Limitations:

Limitations included missing information about adherence for participants with missing data and reasons for dropout.

Conclusions:

Participants with mild and moderate impairments after stroke who received individualized regular coaching established and maintained moderate-to-good adherence to daily physical activity and weekly exercise over time.

PMID:
30329136
DOI:
10.1093/ptj/pzy126

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