Motivational Strategies for Stroke Rehabilitation: A Delphi Study

Abstract

The primary objective was to provide a list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. The secondary objective was to identify the types of information that are important when selecting motivational strategies. Design: Delphi study. Setting: On-site survey at academic conferences and web-based survey. Participants: Rehabilitation experts (NZ198) including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least 5 years. Intervention: Not applicable. Main Outcome Measures: Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less. Results: A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information regarding patient health status, environmental factors, and personal factors were deemed very important or important in determining which motivational strategies to use. Conclusions: We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.

Gamified Neurorehabilitation Strategies for Post-stroke Motor Recovery: Challenges and Advantages

“…There is evidence to suggest that encouraging exercises in a highly engaged state can significantly improve therapeutic outcome [14]. Furthermore, maintaining high levels of motivation in stroke survivors also appears to be an important feature of successful stroke rehabilitation intervention [15].…”

Biomechanical Assessment of Post-Stroke Patients’ Upper Limb before and after Rehabilitation Therapy Based on FES and VR

“…Rehabilitation in post-stroke patients is based on the training of patients with compensatory strategies [ 11 ]. On the one hand, according to several studies, motivation critically influences motor and functional outcomes for people with orthopedic and neurological disorders [ 12 ]. A high adherence rehabilitation program is indicative of motivation [ 12 , 13 , 14 , 15 ].…”

“…On the one hand, according to several studies, motivation critically influences motor and functional outcomes for people with orthopedic and neurological disorders [ 12 ]. A high adherence rehabilitation program is indicative of motivation [ 12 , 13 , 14 , 15 ]. The lack of motivation is a barrier to physical activity and training after stroke [ 12 , 16 , 17 ].…”

“…A high adherence rehabilitation program is indicative of motivation [ 12 , 13 , 14 , 15 ]. The lack of motivation is a barrier to physical activity and training after stroke [ 12 , 16 , 17 ]. Various strategies are used to motivate stroke patients in clinical practice with positive outcomes such as virtual reality [ 12 ].…”

Physiotherapists Use Different Motivational Strategies Tailored to an Individual’s Condition: A Qualitative Study

“…9, 12, 13 We previously reported that rehabilitation professionals used a range of motivational strategies to stroke rehabilitation based on comprehensive consideration of the individuals’ health-related information, suggesting that they use individual-tailored motivational strategies. 14, 15 However, to our knowledge, it remains to be established how physiotherapists select their motivational strategies for each individual. Rehabilitation professionals tend to acquire skills to motivate individuals through their clinical experience.…”