An Upper Extremity Self-Exercise Programme Increases Duration of Exercise in an Acute Rehabilitation Unit and Adherence After Discharge


  • Ei Mon Zaw
  • Christine Alejandro Visperas
  • Tricia Chew Li Ting
  • San San Tay


stroke, upper extremity, exercise, treatment adherence, rehabilitation


Objectives: To assess the effects of an upper extremity self-exercise programme within an acute inpatient rehabilitation unit on the duration of inpatient exercise and post-discharge treatment adherence.

Study design: Observational study.

Setting: Acute inpatient rehabilitation unit within Changi General Hospital, Singapore.

Subjects: Stroke patients with SAFE (Shoulder Abduction Finger Extension) score not less than 5, admitted to the Inpatient Rehabilitation Unit between July 2019 and March 2020.

Methods: This study was initiated as a quality improvement project. The self-exercise programme was adopted from TRIO (Targeted Rehabilitation Improved Outcomes) Home Programme. It was applied as an adjunct to conventional neurorehabilitation. The duration of daily self-exercise was documented. Patient’s feed-backs were obtained before discharge. Post discharge 4-6 weeks, adherence to the programme was followed up via a telephone call.

Results: Two hundred and fifteen stroke patients were screened. Thirty patients participated in the project.  While admitted, the median number of days spent in the upper extremity self-exercise programme was 6 days with an average of 25.88 (SD 11.80 minutes) per session. Eighty-three percent of patients gave feedback that the programme was helpful for their recovery.  On follow up, 56.7% reported continued adherence after discharge and 36.7% were not contactable.

Conclusions: After the early implementation of an upper extremity self-exercise adopted from the TRIO Home Programme within an acute inpatient rehabilitation unit, the average time spent during admission (25.88 minutes) is approaching the minimum recommendation duration of 30 minute per session and promotes treatment adherence after discharge.

Keywords: stroke, upper extremity, exercise, treatment adherence, rehabilitation


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