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Remote Therapeutic Monitoring Enhances Adherence to a Home Exercise Program in Chronic Stroke

Year: 2026

Type: article

Abstract: BACKGROUND: Poor adherence to home exercise programs is a persistent challenge in physical rehabilitation and beyond. Data suggest that follow-up telehealth visits featuring behavior change techniques can improve adherence. However, the optimal frequency of behavioral support for effective self-management of technology-enabled home exercise programs remains unclear. This paper investigates how adherence to home exercise varies with the number of follow-up visits holding the type of exercise constant and measuring adherence objectively. METHODS: = 111) were assigned 15 h of asynchronous video game-based home exercise over 3 weeks. Participants received behavioral support during (a) one single in-person session, (b) four in-person sessions, or (c) four in-person sessions plus six remote teleconsultations. Each consultation incorporated standardized behavior change techniques-contracting, feedback, self-monitoring, action planning, and guided problem solving-to promote increased paretic arm use during daily activities. The primary outcome was adherence (minutes exercising), objectively captured by the gaming system for 87 participants. RESULTS: Six telehealth visits with remote therapeutic monitoring (RTM) increased home exercise completion by 3.3 h [95% CI: 0.008, 6.60]; each remote or in-person consultation was associated with an estimated 34 min of additional asynchronous home exercise. CONCLUSIONS: RTM, which does not require travel to a healthcare facility, is a time-efficient modality to enhance therapeutic engagement. Behaviorally focused telehealth visits boost stroke survivors' adherence to a structured home exercise program.

Source: Healthcare

DOI: 10.3390/healthcare14162634

Authors: Lynne V. Gauthier, Gitendra Uswatte, Deborah S. Nichols-Larsen, Nancy Strahl, Rachel Wolpert, Roger Crawfis