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

Background. Stroke leads to physical problems, commonly paralysis, cognitive, sensory, perceptual and communication problem. Physical inactivity among stroke patients is high 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. Objective. To review the literature on the factors that influence stroke patients' adherence to physical activity (PA) and to identify the intrapersonal, interpersonal and environmental factors that affect the adherence of stroke patients' towards PA. Methods. Four electronic databases (EBSCO: CINAHL Plus with Full text, Willey Online Library, and ScienceDirect) from 2008 to 2019 reporting any factors that affecting stroke people participate in the physical activity. The methodological quality of the studies was appraised using McMaster critical appraisal tools and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for online searching strategy. Results. 10 articles met the inclusion criteria. The intrapersonal factors include physical impairment, balance, and mobility, fear of fall, aging, forgetful, reduce in self-efficacy and exercise benefits. Interpersonal factors were social support, lack of attendant and support from health-care, physiotherapist or gym trainer. Economic factors, transportation, and exercise facility were the environmental factors that influence stroke patient adherence to PA. Conclusions. 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 PA among stroke patients.