Factors influencing stroke patient adherence to physical activity: a systematic review

Abstract

Stroke generally leads to physical problems, most commonly paralysis, cognitive, sensory, perceptual, and communication problem. During the recovery process, physical activity plays an important role in improving patients. However, physical inactivity among stroke patients is high, including those in the acute and chronic stage. The adherence of them towards exercise and rehabilitation therapy declined after discharge, thus lead to poor outcomes of recovery. To review the literature on the factors that influence stroke patients' adherence to physical activity and to identify the intrapersonal, interpersonal, and environmental factors that affect the adherence of stroke patients' towards physical activity. Four electronic databases (EBSCO: CINAHL Plus with Full text, Willey Online Library, and ScienceDirect) were searched from 2008 to 2019, reporting any factors that affecting stroke people participate in the physical activity. Articles were included if they examined the factors that influence stroke patients' adherence to physical activity and were written in English. The methodological quality of the studies was appraised using McMaster critical appraisal tools, and PRISMA guidelines were used for online searching strategy. A narrative summary of findings was undertaken reporting on individual study characteristics, country of origin, participants, and potential factors. 10 articles met the inclusion criteria. The intrapersonal factors include physical impairment, balance, and mobility, fear of falls, aging, forgetful, reduce in self-efficacy, and exercise benefits. Interpersonal factors were social support, lack of attendant and support from healthcare, physiotherapist, or gym trainer. Economic factors, transportation, and exercise facility were the environmental factors that influence stroke patient adherence to physical activity. These three factors were interrelated to change the individual perception towards exercise among stroke patients. This review enables the development of an intervention to improve participation in physical activity among stroke patients.