Personal and social factors that influence physical activity levels in community-dwelling stroke survivors: A systematic review of qualitative literature

Abstract

Objectives: To determine the personal and social factors perceived to influence physical activity levels in stroke survivors. Data sources: Four electronic databases (MEDLINE, CINAHL, PubMed and Embase) were searched from inception to November 2020, including reference and citation list searches. Study selection: The initial search yielded 1499 papers, with 14 included in the review. Included articles were peer-reviewed, qualitative studies, reporting on the perceived factors influencing physical activity levels of independently mobile community-dwelling adults, greater than 3 months post stroke. Data extraction: Data extracted included location, study aim, design, participant and recruitment information and how data were collected and analysed. Data synthesis: Thematic analysis was undertaken to identify meanings and patterns, generate codes and develop themes. Five main themes were identified: (i) Social networks are important influencers of physical activity; (ii) Participation in meaningful activities rather than ‘exercise’ is important; (iii) Self-efficacy promotes physical activity and physical activity enhances self-efficacy; (iv) Pre-stroke identity related to physical activity influences post-stroke physical activity; and (v) Formal programmes are important for those with low self-efficacy or a sedentary pre-stroke identity. Conclusions: Physical activity levels in stroke survivors are influenced by social activities and support, pre-stroke identity, self-efficacy levels and completion of activities that are meaningful to stroke survivors.

Physical inactivity after stroke: Incidence and early predictors based on 190 individuals in a 1-year follow-up of the Fall Study of Gothenburg

“…The fact that a low level of physical activity before stroke is associated with physical inactivity 1 year after stroke is in line with previous findings ( 12 , 28 ) and with a recently published paper in which physical activity levels were said to be influenced by pre-stroke identity related to physical activity by stroke survivors ( 29 ). As physical inactivity prior to a stroke constitutes a risk factor for physical inactivity after a stroke, in parallel with other benefits of physical activity ( 30 ), great attention should be paid to physical activity as an intervention with high potential.…”

Post-Stroke Experiences and Rehabilitation Needs of Community-Dwelling Chinese Stroke Survivors: A Qualitative Study

“…Aside from volunteer involvement, survivors’ experiences also reveal a need for stronger social support networks to facilitate them in their recovery and re-engagement in daily life activities. Noting the importance of physical activity in rehabilitation for example, survivors felt more confident in their mobility when they had a companion who they could rely on in case of potential mishaps, echoing findings from past studies, which note that support from partners or family members was a key facilitator of physical activity [ 29 , 30 ]. Moreover, evidence also suggests that rehabilitation interventions that actively involve survivor family caregivers can improve key outcomes such as functional independence and psychological health [ 31 , 32 ].…”

The process of commitment to exercise among stroke survivors in Canada

“…Previous work has also described a separation between pre‐stroke and post‐stroke life secondary to the effects of stroke (Dowswell et al., 2000; Reed et al., 2010), and has suggested that people living with stroke recognised and appreciated the positive effects of physical activity through comparison of themselves with stroke to their pre‐stroke lives (Morris et al., 2017). A systematic review of qualitative literature on factors influencing physical activity levels post‐stroke underscored the significance of participation in meaningful activities above 'exercise' alone, as well as the significance of pre‐stroke identity in influencing post‐stroke physical activity (Espernberger et al., 2021). These findings suggest that, as part of education about exercise post‐stroke in the community, healthcare providers should emphasise components of exercise programs that will guide individuals towards achieving their pre‐stroke selves, including descriptions of how exercise participation will link to and achieve functional goals.…”