SUPERVISED EXERCISE AFTER MINOR STROKE: AN EVALUATION FROM THE PERSPECTIVE OF PATIENTS AND HEALTHCARE PROFESSIONALS

TL;DR

A supervised exercise program called The Stroke School helps patients after minor strokes stay active and safe, but maintaining long-term exercise remains a challenge.

Contribution

The Stroke School is a novel supervised exercise program initiated before hospital discharge to promote long-term physical activity in minor stroke patients.

Findings

The Stroke School intervention ensured patient safety through frequent exercise and follow-up sessions.

Patients were highly motivated to exercise immediately after stroke diagnosis.

Physiotherapists noted challenges in empowering patients to exercise independently after the program.

Abstract

Maintaining long-term physical activity after a stroke is challenging. “The Stroke School”, a standardized physical exercise programme, was developed and patients’ and healthcare professionals’ experiences of participating were explored.

Qualitative study.

Eight patients with minor stroke or transient ischaemic attack (TIA) completed a feasibility study on The Stroke School intervention in conjunction with their supervising municipal physiotherapists (n = 5). All informants were invited for semi-structured focus-group interviews, during which they were asked to reflect on their experience attending The Stroke School. Audio recordings from 3 focus-group interviews lasting 90 min each were transcribed to text verbatim and analysed with qualitative content analysis.

Thirteen informants attended 3 focus-group interviews. Five categories were identified (i–iii representing the patients’ perspective and iv–v the physiotherapists’ perspectives): (i) window of opportunity, (ii) benefits of participating in the study, (iii) strengths and pitfalls of transitioning from the hospital to the municipalities, (iv) effective communication across sectors, and (v) empowering patients to continue exercising independently.

The Stroke School intervention was feasible, provided patient safety throughout the study, and resulted in effective communication and collaboration across sectors. However, identifying factors that facilitate life-long exercise behaviour changes is still warranted.

Patients with non-disabling stroke do not systematically receive a physical exercise programme following hospital discharge as their symptoms are often resolved at this point. However, initiating and maintaining physical activity independently to reduce stroke risk factors can be challenging post-stroke due to fatigue, reduced mental energy, and cognitive dysfunction. We designed a supervised exercise study (The Stroke School), initiated before hospital discharge. Furthermore, we explored patients’ and healthcare professionals’ experiences of participating in the supervised physical exercise programme. The results showed that the exercise intervention helped to ensure patient safety through frequent exercise sessions, follow-up examinations, and repeated counselling sessions. Patients were highly motivated to exercise immediately after their stroke diagnosis. The municipal physiotherapists experienced effective communication and collaboration across sectors but empowering the patients to exercise independently after ending 12 weeks of supervised exercise was challenging.

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