Home-based self-training: A qualitative exploration of the experiences of individuals with chronic-stroke

ObjectiveTo explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training.DesignA qualitative study.SettingCommunity.SubjectsIndividuals with chronic-stroke.InterventionsParticipants underwent a structured 5-week home-based upper-extremity self-training via videogames or the Graded Repetitive Arm Supplementary Intervention which includes activities using everyday objects.Main measuresParticipants were interviewed following their participation in the self-training intervention, using a semi-structured interview. Interviews were transcribed verbatim and then analyzed using thematic analysis. Findings were validated through author discussions.ResultsTwenty-two participants (63% men) were included, aged 33 to 80, 6-36 months post-stroke. Participants had preserved cognitive ability, were mostly independent in daily living, and had a moderate upper-extremity motor ability (median (interquartile range (IQR)) Fugl-Meyer Motor Assessment score: 41 (29-47)/66 points). Three main themes were identified: 1) personal factors (e.g. devotion to perform self-training, commitment to the study, and personal roles), 2) self-training factors (e.g. experience and its influence on general condition), 3) environment-related factors (e.g. training equipment, home environment, and family support). The structured intervention and family support led to motivation and commitment. Challenges included time constraints, pain, and fatigue.ConclusionsThis qualitative study deepens understanding of home-based self-training experiences among individuals with chronic-stroke, highlighting how motivational, environmental, and self-training factors interact to shape long-term adherence. These insights can guide clinicians tailor interventions to promote long-term adherence and engagement by addressing individual, environmental, and task-related factors, and by identifying participants who may require additional support.