Adherence to exercise rehabilitation programmes in stroke survivors: a scoping review.

Abstract

Objectives: To identify how exercise adherence is reported in research which focuses on enhancing cardiorespiratory and muscular fitness in stroke survivors.

Design: Systematic scoping review.

Data sources: Scopus, PubMED/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO/PsycARTICLES and Web of Science.

Eligibility criteria for selecting studies: The review sought published reports involving a cardiorespiratory or resistance training exercise intervention for people who experienced a stroke ≥6 months prior to participation. Reports were screened by two reviewers and were assessed for methodological quality using the Mixed Methods Appraisal Tool.

Results: 37 reports (randomised trials=30, interventions without control=5, non-randomised trial=1, dose escalation trial=1; total n=1347 participants) out of 6732 records met the inclusion criteria. 29 reports (78%) documented intervention adherence by describing participant completion rates, indicating 65-100% adherence. Exercise session adherence within intervention was identifiable in 16 reports (43%), 12 of which recorded session attendance, signifying 61-100% adherence. There were also measures of the intensity or duration participants sustained during sessions in 14 studies. Only one study measured postintervention (ie, at least 3 months after intervention completion) exercise adherence, and two studies actively supported participants' exercise motivation.

Conclusion: Adherence is commonly measured by intervention completion rates. Despite its importance for intervention effectiveness, less than half of studies measured exercise session adherence within interventions. Future research should address this limitation to better understand how stroke survivors engage with exercise.