Evidence map›Paper›PMID 34992120›Full record

ArticleBMJ open2022

Development of strategies to support home-based exercise adherence after stroke: a Delphi consensus.

Amreen Mahmood, Anagha Deshmukh, Manikandan Natarajan, Dianne Marsden, Glade Vyslysel, Sebastian Padickaparambil, Shwetha Ts, Artur Direito, Senthil Kumaran, Girish N and 6 more

Abstract readConsensus Statement
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Amreen MahmoodPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.ORCID 0000-0002-2803-3598
Anagha DeshmukhClinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Manikandan NatarajanPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Dianne MarsdenHunter Stroke Service, Hunter New England Local Health District, New Lambton, New South Wales, Australia.
Glade VyslyselWestlakes Community Rehabilitation Team, Hunter New England Local Health District, Toronto, NSW, Australia.
Sebastian PadickaparambilClinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Shwetha TsClinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Artur DireitoCentre for Behaviour Change, University College London, London, UK.
Senthil KumaranPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Girish NPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Harpreet SachdevNeurology, All India Institute of Medical Sciences, New Delhi, India.
Sundar Kumar VeluswamyPhysiotherapy, MS Ramaiah Medical College, Bangalore, Karnataka, India.
Suruliraj KarthikbabuPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bangalore, Karnataka, India.
B UnnikrishnanCommunity Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Coralie EnglishPriority Research Centre Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia.ORCID 0000-0001-5910-7927
John M SolomonPhysiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India john.solomon@manipal.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop a set of strategies to enhance adherence to home-based exercises after stroke, and an overarching framework to classify these strategies.

methodWe conducted a four-round Delphi consensus (two online surveys, followed by a focus group then a consensus round). The Delphi panel consisted of 13 experts from physiotherapy, occupational therapy, clinical psychology, behaviour science and community medicine. The experts were from India, Australia and UK.

resultsIn round 1, a 10-item survey using open-ended questions was emailed to panel members and 75 strategies were generated. Of these, 25 strategies were included in round 2 for further consideration. A total of 64 strategies were finally included in the subsequent rounds. In round 3, the strategies were categorised into nine domains-(1) patient education on stroke and recovery, (2) method of exercise prescription, (3) feedback and supervision, (4) cognitive remediation, (5) involvement of family members, (6) involvement of society, (7) promoting self-efficacy, (8) motivational strategies and (9) reminder strategies. The consensus from 12 experts (93%) led to the development of the framework in round 4.

conclusionWe developed a framework of comprehensive strategies to assist clinicians in supporting exercise adherence among stroke survivors. It provides practical methods that can be deployed in both research and clinical practices. Future studies should explore stakeholders' experiences and the cost-effectiveness of implementing these strategies.

Indexed as

StrokeDelphi TechniqueExerciseHumansSurvivorsrehabilitation medicinestrokestroke medicine

Identifiers

PMID34992120
PMCPMC8739434

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.