Predictors of Adherence to a Structured Exercise Program and Physical Activity Participation in Community Dwellers after Stroke

Abstract

Aim. To investigate predictors of adherence to group-based exercise and physical activity participation among stroke survivors. Methods. 76 stroke survivors participated (mean age 66.7 years). Adherence was the percentage of classes attended over one year. Physical activity was the average pedometer steps/day measured over seven days at the end of the trial. Possible predictors included baseline measures of demographics, health, quality of life, falls, fear of falling, cognition, and physical functioning. Results. Mean class attendance was 60% (SD 29%). Only one variable (slow choice stepping reaction time) was an independent predictor of higher class attendance, explaining 5% of the variance. Participants completed an average of 4,365 steps/day (SD 3350). Those with better physical functioning (choice stepping reaction time, postural sway, maximal balance range, 10-m walk, or 6-min walk) or better quality of life (SF-12 score) took more steps. A model including SF-12, maximal balance range, and 6-min walk accounted for 33% of the variance in average steps/day. Conclusions. The results suggest that better physical functioning and health status are predictors of average steps taken per day in stroke survivors and that predicting adherence to group exercise in this group is difficult.

Combining Fast-Walking Training and a Step Activity Monitoring Program to Improve Daily Walking Activity After Stroke: A Preliminary Study

“…This effect appears to have the greatest benefit for those who were most impaired at baseline. Previous cross-sectional studies have found a significant relationship between 6MWT distance and real-world step activity in persons with chronic stroke 13, 45, 46 , thus, it is possible that improvements in one benefit the other.…”

Barriers to healthy-lifestyle participation in stroke

“…Adherence is vital for sustainable long-term benefits from exercise; thus, these issues raised are relevant. The only factor significantly predicting attendance rates in a communitybased falls prevention programme after stroke was dynamic standing balance (Tiedemann et al, 2012), showing that physical activity participation is influenced by locomotor ability. Mobility-impaired stroke survivors may require specific and targeted exercise intervention.…”

Step by step: A proof of concept study of C-Mill gait adaptability training in the chronic phase after stroke

“…Physical activity levels have been demonstrated to be related to balance and mobility performance in community-dwelling individuals after stroke, with walking speed being a strong predictor (36). Hence, the presently observed improvement in physical functioning may have enabled the participants to become more physically active in daily life.…”