ABSTRACT:
Stroke rehabilitation is vital in improving mobility, achieving functional independence, and enhancing psychological health. However, sticking to rehabilitation programs is a significant hurdle, especially in low- and middle-income nations like India. Poor adherence is associated with delayed recovery, more significant disability, and an increased likelihood of secondary issues. Although a growing body of evidence highlights the significance of rehabilitation adherence, research on its effects in the Indian context remains limited. This study aims to assess the connection between adherence to rehabilitation and functional recovery outcomes in stroke survivors. It specifically investigates how adherence influences mobility enhancements (Functional Mobility Scale, Timed Up, and Go Test), independence in daily activities (Barthel Index), and psychological well-being (PHQ-9 Depression Scale). A prospective cohort study was conducted at Index Medical College, Hospital and Research Center, involving 200 individuals who had survived a stroke. The participants were categorized into two groups: High-Adherence Group (80% or more adherence, n = 100). Low-Adherence Group (adherence below 80%, n = 100). Adherence to rehabilitation was monitored through digital attendance records, patient rehabilitation journals, and weekly follow-ups by nurses. Functional mobility, independence in activities of daily living (ADL), and psychological well-being were assessed at baseline (Week 0), Week 12, and Week 24. Functional Mobility: Higher adherence levels were significantly associated with enhanced mobility improvements (FMS: 4.38±0.45 compared to 3.10±0.51, p<0.001; TUG: 11.9±2.1 seconds versus 16.5±2.8 seconds, p<0.001). ADL Independence: By the 24th week, individuals with high adherence exhibited a 24% increase in Barthel Index scores (84.1±10.2 as opposed to 67.5±9.4, p<0.001). Psychological Well-Being: Greater adherence correlated with a 48% more substantial reduction in PHQ-9 depression scores (4.8±1.9 compared to 9.2±2.7, p<0.001). Multivariate Regression Analysis: Adherence to rehabilitation emerged as the most significant predictor of functional recovery (ß = +4.5, p<0.001). Stroke survivors who closely follow rehabilitation nursing interventions tend to experience enhanced mobility, increased independence in activities of daily living (ADL), and better psychological health. Since adherence is the most significant factor in recovery, hospitals are encouraged to implement nursing-led adherence initiatives and utilize digital tools for tracking adherence to boost patient involvement. Future studies should investigate the long-term impacts, explore telerehabilitation approaches, and consider gender-specific adherence methods to improve stroke recovery results further.
Cite this article:
Shruti M. Roy. Impact of Rehabilitation Adherence on Functional recovery among Stroke Survivors: A Prospective Cohort Study in India. International Journal of Advances in Nursing Management.2026;14(2):81-6. doi: 10.52711/2454-2652.2026.00017
Cite(Electronic):
Shruti M. Roy. Impact of Rehabilitation Adherence on Functional recovery among Stroke Survivors: A Prospective Cohort Study in India. International Journal of Advances in Nursing Management.2026;14(2):81-6. doi: 10.52711/2454-2652.2026.00017 Available on: https://www.ijanm.com/AbstractView.aspx?PID=2026-14-2-3