Home-based self-training: A qualitative exploration of the experiences of individuals with chronic-stroke

Objective: To explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training. Design: A qualitative study. Setting: Community. Subjects: Individuals with chronic-stroke. Interventions: Participants underwent a structured 5-week home-based upper-extremity self-training via videogames or the Graded Repetitive Arm Supplementary Intervention which includes activities using everyday objects. Main measures: Participants were interviewed following their participation in the self-training intervention, using a semi-structured interview. Interviews were transcribed verbatim and then analyzed using thematic analysis. Findings were validated through author discussions. Results: Twenty-two participants (63% men) were included, aged 33 to 80, 6–36 months post-stroke. Participants had preserved cognitive ability, were mostly independent in daily living, and had a moderate upper-extremity motor ability (median (interquartile range (IQR)) Fugl-Meyer Motor Assessment score: 41 (29–47)/66 points). Three main themes were identified: 1) personal factors (e.g. devotion to perform self-training, commitment to the study, and personal roles), 2) self-training factors (e.g. experience and its influence on general condition), 3) environment-related factors (e.g. training equipment, home environment, and family support). The structured intervention and family support led to motivation and commitment. Challenges included time constraints, pain, and fatigue. Conclusions: This qualitative study deepens understanding of home-based self-training experiences among individuals with chronic-stroke, highlighting how motivational, environmental, and self-training factors interact to shape long-term adherence. These insights can guide clinicians tailor interventions to promote long-term adherence and engagement by addressing individual, environmental, and task-related factors, and by identifying participants who may require additional support.