ENABLERS AND BARRIERS OF ADHERENCE TO HOME EXERCISE PROGRAMMES AFTER STROKE: CAREGIVER PERCEPTIONS

Scorrano M1, Ntsiea MV1, Maleka D21University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa, 2Sefako Makgatho University of Health Sciences, Physiotherapy, Pretoria, South AfricaBackground: In stroke rehabilitation, the goal is to discharge patients at their optimal functional level, however, this level of independence is not always reached at discharge due to decreased length of stay and a high demand for beds. Thus, patients rely upon caregivers to assist them not only with activities of daily living but also with home exercise programmes.Purpose: The purpose of this study was to establish caregivers' perceived enablers and barriers of adherence to home exercise programmes in stroke survivors.Methods: A qualitative study design was used with in-depth interviews of the caregivers of stroke survivors who were dependent in functional activities.Results: The average age of the caregivers was 47.8 years (±13.96) years and all of them were the stroke survivors' family members. The most common enablers of adherence to home exercise programmes were self -motivation, external motivation from friends and family, having a daily routine, spirituality, caregivers' attitude and desires, and caregiver knowledge. The most common barriers of adherence to home exercise programmes were general health issues, caregiver having other responsibilities, lack of family and social support, caregiver burden and stress, low self-efficacy and mood, and fear of falling.Conclusion(s): Adherence to home exercise programmes is multifactorial and does not only relate to the stroke survivor alone. Caregivers have a lot of responsibilities and experience emotional strain and burden. This has an influence on stroke survivors' adherence to home exercise programmes as they rely upon caregivers for assistance.Implications: The established enablers and barriers of adherence to home exercise programmes may assist physiotherapists, as well as other allied health professionals to: Identify patients at risk for non-adherence, suggest methods to reduce the negative impact of the barriers and increase the positive impact of the enablers, adapt home exercise programmes and family training to optimise adherence and offer the necessary support required by stroke survivors and caregivers. If adherence is maximised, stroke survivors will have better functional outcomes due to the ongoing rehabilitation process.Keywords: Stroke, Adherence, Home exercise programmeFunding acknowledgements: No fundingTopic: Neurology: stroke; Neurology; Disability & rehabilitationEthics approval required: YesInstitution: University of the WitwatersrandEthics committee: Human Research Ethics Committee of the University of the WitwatersrandEthics number: M150152All authors, affiliations and abstracts have been published as submitted.