探討依據5A行為介入模式所設計的遵從性增強策略諮詢技巧可否增進中風患者居家運動 之遵從性並促進動作功能恢復。方法：徵召18位亞急性單側中風個案，分層隨機納入遵從性增強 (介入）組及一般居家運動（對照）組。於個案出院前2週教導居家物理治療運動並進行前測。介入 組使用5A (詢問、勸吿、協助、安排、同意）行為介入諮詢，並使用運動日誌及計步器做為增強 物。出院後第4及12週回院進行後測及追蹤評估。結果評估包括10公尺行走測試、功能性行走分 類、桕格氏平衡量表、日常活動日誌、失能者身體活動量表及居家運動核對清單。另外記錄介入 組之每日活動步數。結果：在前測時除介入組左側偏癱個案人數比例顯著多於對照組外，兩組無 顯著差異。介入組相較於對照組在出院後第4週對柔軟度運動（211%及90%)及平衡運動（38%及 15%)有顯著較佳的遵從度，且介入組在第4週的10公尺行走測驗及第12週之功能性行走分類表 現顯著優於對照組（/7<0.05)。兩組在柏格氏平衡量表及失能者身體活動量表、居家運動核對清單 表現上未達顯著差異。結論：5A行為介入諮詢有益於增進中風個案出院後4週期間的運動遵從度 以及第12週時的行走功能，物理治療師可在臨床上加入此種諮詢技巧以利促進居家物理治療遵從 度的增加並維持物理治療的長期效果。

The 5A (Ask, Advise, Assist, Arrange and Agree) protocol is a behavior counseling technique which may improve patients，adherence to health promoting behavior. This study aimed to investigate the effects of utilizing the 5A protocol on the adherence of home rehabilitation program and on motor function recovery in stroke patients. Methods: This was a randomized, controlled, double-blind clinical trial. Eighteen subacute stroke in-patients (average age: 60.8 y/o; male/female= 13/5) were recruited and randomly assigned into the Adherence Enhancement (AE) group or the Conventional Home Program (CHP) group. Both groups received home exercise instructions and demonstrative sheets before discharge from the rehabilitation ward. Only the AE group instructed based on the 5A Behavior Intervention Protocol and used self-reports of daily activity diary and pedometer while walking as enhancers for 4 weeks. The outcome measurements included the 10-meter walking test (10MWT), the Functional Ambulation Category (FAC), the Berg Balance Scale (BBS), the daily activity diary, and the Specific Home Exercise Checklist between the two groups at the end of the 4th week post discharge. Follow-up was scheduled during the 12th week post discharge. Results: There were no significant differences on the parameters of basic data, except the hemiplegic side. The AE group subjects exhibited better adherence in some of self-reported of daily activity diary such as flexibility exercise (AE=211%; CHP=90%) and balance exercise (AE=38%; CHP=15%) at 4th week, but not at 12th week after discharge. Both groups improved significantly on 10MWT and BBS (p<0.001) at both 4th and 12th weeks after discharge. The AE group subjects exhibited better performance in the 10MWT and FAC than the CHP group subjects (p<0.05) at follow up. However, the groups did not differ significantly on the BBS, Physical Activity Scale for Individuals with Physical Disability, and Specific Home Exercise checklist. Conclusion: Stroke patients with enhanced intervention pro-gram on the adherence of home rehabilitation program exhibited better adherence in some of the home program exercise, and better performance in gait speed and community walking ability than the patients who did not receive the intervention program. Therefore, we can conclude that there are some effects of an enhanced intervention program on the adherence of home rehabilitation program in stroke patients. It is suggested that the 5A protocol be adopted by physical therapists for home exercise instructions of stroke patients.