Adherence to use of a home-based exercise DVD in people with Huntington disease: participants' perspectives

Abstract

Background: Individualized exercise instruction on a regular basis may be desirable for people with Huntington disease (HD). Sustained interventions, however, may not be the most feasible for lifelong disease management. It is critical, therefore, for physical therapists to find ways to facilitate engagement in independent exercise programs. The capabilities of DVD technology can make the DVD a useful format to facilitate engagement for people with HD who have motivational and cognitive problems.

Objective: The purpose of this study was to explore how people with HD used a home-based exercise DVD and how it was perceived by the participants and their caregivers.

Design: An exploratory, mixed-method design was used in this study.

Methods: Fifteen participants with HD were provided with an exercise DVD, developed by the authors, to support their engagement in a home-based exercise program. Exercise diaries were used to record adherence rates. Semistructured interviews were conducted to explore what factors affected the usability of the DVD. Conversations were audio recorded and fully transcribed. Content analysis approach was used to analyze the interviews.

Results: Most of the participants (11/15, 73.3%) adhered well to the use of the DVD. Participants felt that the exercises were suitable. Commitment of the caregiver as a key to the success of the program was the main theme that emerged from the data. Participants identified barriers and facilitators that affected adherence to using the exercise DVD and described management strategies that helped promote adherence to the exercise program.

Conclusions: The DVD was perceived to be suitable and supportive. The DVD could be appropriate for use in supporting people with HD to engage in exercise at home, either outside of therapy sessions or upon completion of a therapy program.