The experience of people with acquired brain injury with home exercise programs: A qualitative descriptive study.

BACKGROUND: Home exercise programs extend the benefits of rehabilitation following acquired brain injury. However, they are not completed consistently. To improve rehabilitation outcomes greater understanding is needed of the patient experience when completing a home programs. OBJECTIVE: This qualitative descriptive study explored perceptions of patients with acquired brain injury regarding their home exercise programs (HEP) following inpatient rehabilitation. METHODS: Forty-eight patients with brain injury were recruited from one rehabilitation hospital. Participants spoke English, were between 18 and 85 years old, had no neurodegenerative disorders, and received HEPs before inpatient rehabilitation discharge. Participants completed semi-structured interviews about six months after discharge. Interviews were audio recorded and transcribed. The qualitative analysis involved an inductive content analysis. Specifically, we used an iterative process of consensus coding and theme extraction. RESULTS: Three primary themes with related subthemes emerged. First, participants expressed positive experiences and attitudes toward HEPs, including understanding the home program, its feasibility and value, adaptations over time, and recommending home programs to other ABI survivors. Second, participants identified facilitating and inhibiting factors to HEP adherence, indicating that their adherence changed over time. Participants identified intrinsic and extrinsic factors affecting adherence. Finally, participants connected their HEP and rehabilitation experiences including discussion of funding and insurance, and their experience or attitudes toward rehabilitation and clinicians. CONCLUSIONS: Clinicians may consider home programs evolving nature, help patients plan for intrinsic and extrinsic factors impacting program completion, and leverage the perceived interconnectedness between home programs and rehabilitation.