ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Impact of Frailty on Rehabilitation Exercise Adherence in Patients with Ischemic Stroke
Provisionally accepted
- 1Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- 2north sichuan medical college, Nanchong, China
- 3Guang'an District People's Hospital of Guang'an City, Guang'an, China
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Objectives To identify the threshold effect of frailty on rehabilitation exercise adherence in patients with ischemic stroke. Methods The study included 307 patients diagnosed with ischemic stroke who were given a questionnaire comprising a general information form, the Rehabilitation Adherence Assessment Scale, and the Frailty Assessment Scale. Univariate and multivariable linear regression were employed to determine factors influencing rehabilitation exercise adherence. Subsequently, restricted cubic splines were utilized to fit a smooth curve and detect potential threshold effects. Results The average score for the rehabilitation exercise adherence index was (54.83 ± 9.32), while the average frailty score was (4.59 ± 2.14). Through univariate analysis, it was found that gender, marital status, living arrangement, household registration type, number of medications, and level of independence are factors influencing rehabilitation exercise adherence. Restricted cubic spline analysis revealed a non-linear relationship between frailty and rehabilitation exercise adherence. The association between frailty score and rehabilitation exercise adherence was found to be insignificant when the score was ≤ 3.98. Conversely, exceeding this threshold revealed a significant decline in the adherence index, with each additional frailty point correlating with a 2.56-point decrease (P < 0.001). Conclusions Rehabilitation exercise adherence is moderate among patients with ischemic stroke, while the prevalence of frailty is notably high. A frailty score above 3.98 might serve as an early indicator of its impact on adherence. Accordingly, rehabilitation programs need to be adjusted to accommodate disease characteristics and sociodemographic factors. Keywords Frailty, rehabilitation exercise, adherence, ischemic stroke, threshold effect analysis
Keywords: Frailty, Rehabilitation exercise, adherence, ischemic stroke, threshold effect analysis
Received: 24 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Long, Wu, Li and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi Wu, frank@nsmc.edu.cn
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