Friday, August 25, 2017

Defining the rehabilitation adherence curve and adherence phases of stroke patients: an observational study

The reason for adherence problems is that there are no protocols with efficacy ratings. If you knew that doing this intervention 15,000 times would result in this recovery 65% of the time, your adherence would likely be very good. But since your doctors and therapists have no clue about how to specifically get you recovered why should you adhere to any intervention?
https://www.dovepress.com/defining-the-rehabilitation-adherence-curve-and-adherence-phases-of-st-peer-reviewed-article-PPA
Authors Yao M, Chen J, Jing J, Sheng H, Tan X, Jin J
Received 18 April 2017
Accepted for publication 14 July 2017
Published 21 August 2017 Volume 2017:11 Pages 1435—1441
DOI https://doi.org/10.2147/PPA.S139854
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Naifeng Liu
Meiqi Yao, Jinhua Chen, Jiyong Jing, Han Sheng, Xing Tan, Jingfen Jin

Nursing Department, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China

Background: Patient adherence is a crucial determinant of rehabilitation in the long term after stroke. However, adherence is inconstant and fluctuates along a time course, and the underlying regular pattern of adherence variation remains to be clarified.
Objective: We aimed to describe the longitudinal pattern of adherence to rehabilitation exercises in stroke patients and to determine different adherence phases based on formulated rehabilitation adherence curve.
Patients and methods: Rehabilitation adherence levels were prospectively collected using the Questionnaire of Exercise Adherence (EAQ) among patients diagnosed with first-onset stroke since the second week of stroke onset, with a follow-up of 24 weeks. SPSS19.0 was used to formulate a fitting curve based on a scatter diagram. Possible causal factors for the different adherence phases are also discussed from the psychological, socioeconomic, and behavioral aspects.
Results: A total of 98 patients were included in this study. General adherence of the included subjects was classified as low to medium during follow-up. The adherence fitting curve was an “S” curve, with the fitting function y =0.005x3-0.211x2+1.963x+52.345. Three phases, namely, rapid increase phase, slow decrease phase, and stable phase, were identified based on the adherence curve, and relevant theories are explored.
Conclusion: Rehabilitation adherence of stroke patients is a dynamic behavioral process that continuously changes along a time course, with a regular pattern of an “S” curve and includes a rapid increase phase, a slow decrease phase, and a stable phase.

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