Factors influencing adherence to home-based exercises among community-dwelling stroke survivors in India: a qualitative study

Purpose: To explore the factors influencing adherence to home-based exercises among community-dwelling stroke survivors using Intervention Mapping (IM) approach. Material and methods: Qualitative interviews were conducted with ten stroke survivors living in semi-urban regions of India. The data were analysed using Atlas.Ti8 software and categorised using the Social Ecological Model. Results: The mean age of the stroke participants was 61 +/- 11 years. Key factors such as lack of awareness about stroke recovery and exercises, poor perceived recovery, hopelessness and lack of emphasis on exercises by healthcare professionals led to non-adherence while commitment, continued supervision, supportive family and society facilitated adherence. Some cultural specific factors such as opting for folk medicine over rehabilitation and social stigma were also identified. Conclusions: The factors which influenced adherence to home-based exercises in stroke are existent at the individual, interpersonal, organisational and community level. This study can lead to the development of effective interventions for promoting exercise adherence among stroke survivors in low and middle income countries (LMICs).