“HIST at HOME”: Care Partner Assisted High Intensity Stepping Training at Home After Stroke

Research

Objectives: The objective of this poster is to investigate the feasibility of patients participating in a care partner assisted high intensity stepping (HIST) program in the home after discharge from inpatient rehabilitation (IR) and describe factors which may influence successful adherence.

Design: Participants with stroke who successfully performed HIST at 60-85% of their heart rate reserve (HRR) or rate of perceived exertion (RPE) of 15-17 for at least 24 minutes, 5 days per week in IR were included. The participants had a care partner who was able to monitor their heart rate or RPE at home and demonstrated the ability to safely assist in HIST in IR. The patient and care partner underwent hands on training sessions for implementing the program while in IR. Patients and their care partner were given written instructions and a tracking calendar. The participants were asked to track exercise intensity and number of minutes exercised per day at home. Follow up emails were sent to participants to retrieve the calendar 1-month post DC. Setting: Supervised physical therapy in IR and care partner assisted exercise at home. Participants: Preliminary results include N=3 persons after acute stroke in IR, discharging to home with care partner support. Interventions: Care partners and participants underwent hands on training for administration of the home-based program prior to DC home. “HIST at HOME” consists of participants engaging in walking training at 60-85% of HRR or RPE of 15-17, for at least 24 minutes, 5 days per week with supervision of trained care partner. Main Outcome Measures: Number of minutes participants walked at the recommended target intensity, number of days exercised, and reports of adverse reactions to the program were tracked.

Results: All patients reported adherence to the recommended program for 1 month after DC. All patients reached the target intensity during walking training at least 5 days per week with supervision of a care partner. No adverse responses were noted.

Conclusions: All patients demonstrated adherence to “HIST at home” with the assistance of a care partner without adverse reactions. Factors including having care partner support, a therapist providing training, and having a 1 month follow up may have a positive influence on adherence. Author(s) Disclosures: There are no financial disclosures.