Assessment of compliance with prescribed activity by hemiplegic stroke patients after an exercise programme and physical activity education

Although post-stroke exercise training programmes improve aerobic capacity and functional capacities in the short-term, the impact on exercise performance at home has not been established.

Objectives: To assess compliance with prescribed physical activity by hemiplegic stroke patients. To compare the patients' stated activity with their actual activity.

Patients and methods: This was a prospective pilot study of nine hemiplegic patients following an exercise training programme. Each patient's activity was measured using an activity monitor (the ActivPAL) before, during and immediately after the programme and then 3months after the end of the programme. The activity actually performed was compared with the levels recommended after a stroke (at least 30minutes of non-stop activity three times a week). Three months after the end of the programme, the patient's stated and actual activities (in terms of frequency and duration) were compared.

Results: Activity patterns changed immediately after the end of the programme. Short-term compliance was good for four patients. However, 3months later, only one patient was performing regular activity in accordance with the guidelines. Hence, medium-term compliance was poor. Most patients overestimated both the duration and frequency of their activity sessions.

Conclusion: Three months after the end of the supervised training programme, compliance with physical activity guidelines was low. The ActivPAL activity monitor is easy to use and performs satisfactorily. It can be used as a tool for activity assessment and education intervention. The use of an actimeter may increase the efficacy of health education interventions, which promote physical activity.