Facilitators and Barriers to Home Exercise Program Adherence in Aphasia: Speech-Language Pathologists' Perspectives

Home exercise programs (HEPs) are beneficial for the rehabilitation process, yet adherence remains low (30%-50%). People with aphasia (PWA) face unique challenges due to deficits in language comprehension and/or expression, but research on facilitators and barriers to achieving HEP adherence in this population is limited. This study examines speech-language pathologists' (SLPs') perspectives on factors that facilitate or hinder adherence to HEPs in PWA.

A 37-item cross-sectional online survey was administered to SLPs treating PWA. A nonprobability purposive sampling method was used. Likert scale responses were analyzed using descriptive statistics and Spearman rho correlations. Open-ended questions were analyzed for patterns and themes.

Of 100 responses, 83 completed surveys were analyzed. Participants were primarily female (~93%) practicing in outpatient settings, with over 21 years of experience. Key facilitators to HEP adherence included motivation (98%), caregiver integration (96%), and incorporating the HEP into daily routines (90%). Moderate positive correlations were found between integrating HEPs into daily routines and perceived relevance (r_s = .500, p < .001), as well as between caregiver involvement and HEP integration into daily life (r_s = .502, p < .001). Facilitators were categorized as internal (motivation, relevance) and external (family and SLP support). Barriers included internal factors (depression, lack of motivation, severity of deficits) and external factors (limited family support, program difficulty, lack of Spanish language resources).

SLPs identified multiple factors influencing HEP adherence. Clinicians should consider these factors when developing HEPs for PWA.

https://doi.org/10.23641/asha.32484204.