Adherence to a long-term follow-up programme after stroke - A prospective longitudinal study assessing adherence to the intervention applied in a randomised controlled trial
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Background: Adherence to rehabilitation programmes is considered an important area of interest in the wake of optimising long-term participation in physical activities after stroke. Purpose: Investigating to what extent patients were adherent to a long-term follow-up programme, applied in a randomised controlled trial. Material and methods: This was a prospective, longitudinal study, following patients for 52 consecutive weeks. The intervention consisted of regular sessions of coaching by a coordinating physiotherapist, aiming to motivate patients to adhere to at least 30 minutes of daily physical activity and 45 minutes of weekly exercise. Patients’ self-reports in training diaries, in addition to adherence reported by the physiotherapist reviewing these, were combined and assessed as the primary outcome measure. Borg’s scale of perceived exertion and Goal attainment scaling were secondary measures. Results: 41 community-dwelling stroke patients (mean age 75.2 years (SD 7.7)), mild to moderately disabled, were included. An average of 47.5% (SD 8.8) and 62.1% (SD 5.0) were adherent to the prescribed amounts of physical activity and exercise, respectively. The amount of exercise increased from the beginning to the end of the follow-up programme (p = 0.039), while a stable amount of physical activity were observed over time (p = 0.604). The majority of training was performed at moderate levels of intensity, while goals were poorly achieved over time. Conclusions: The present findings indicate that stroke patients participating in a long-term follow-up programme demonstrated good adherence to exercise and moderate adherence to physical activity over time. Whether activity levels were permanently established beyond the current time of observation is yet to be explored in future research.