Barriers and facilitators to long-term engagement in physical activity following stroke and interventions to support engagement: A literature review

Background Physical activity is beneficial for functioning, health and fitness after stroke. However even after attending exercise programmes, most people with stroke do not participate long-term in recommended levels of physical activity. Interventions that address barriers and support long-term engagement in physical activity after stroke are required. This study aimed a) to conduct structured literature reviews examining barriers and facilitators to long-term engagement in physical activity after stroke and b) to review the nature and effectiveness of interventions to promote long-term engagement in physical activity in the stroke population.

Methods Two searches were conducted. Medline, CINAHL, Embase, AMED, British Nursing Index and Psych Info were searched between 1996 and 2010. Search a) used search terms and synonyms for stroke, physical activity, qualitative research and questionnaires. Search b) used search terms and synonyms for stroke, physical activity and adherence.

Results Search a) yielded 10 publications of which 81 were relevant. Only 3 studies investigated barriers to activity after stroke. Search b) yielded 1403 publications of which 56 were relevant. Only 1 study examined interventions for long-term physical activity adherence.

Conclusions Review of the relevant literature show that a) Preliminary information exists regarding motivational, psychological and environmental factors that may prevent stroke survivor's engagement in activity, however information is limited to volunteer populations in urban areas b) Although health behaviour theories have been examined for applicability to physical activity after stroke, there appear to be few interventions of known efficacy for the promotion of long-term adherence to physical activity after stroke.