Abstract Background Many adults do not meet physical activity recommendations for optimal health, and this is often because people find it difficult to maintain physical activity in the long term. This study focuses on identifying and synthesising factors that may influence the maintenance of physical activity in adults with and without known health conditions. Method A systematic review and qualitative synthesis using thematic analysis was conducted. Four databases (MEDLINE, SPORT Discus, APA, and Web of Science) were systematically searched for studies published from inception to February 2023 that included qualitative data about people’s experiences of maintaining physical activity. Results A total of 9337 abstracts were screened and 68 studies from 14 countries were included. Six main themes were identified: (1) influence of others (e.g. four forms of social support, accountability); (2) contextual and environmental influences (e.g. cost and access of physical activity, weather); (3) health-related influences (e.g. reflexivity about how physical activity improves health conditions, weight control); (4) making it work (e.g. flexibility, prioritising exercise); (5) habits; and (6) psychological processes (e.g. enjoyment, identifying as a physically active person). Conclusion People who maintained their participation in physical activity found it enjoyable, prioritised it, and integrated it into their daily routine. Participants were motivated to continue being physically active when they realised the benefits for their health. Social support, in particular companion support, was a key component facilitating continued engagement. Findings specific to maintenance of physical activity included reflexivity of how physical activity benefited health, flexibility, and identifying as a physically active person.
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