Approaches to influencing leisure participation following stroke: A scoping review.

Abstract

ObjectiveTo review the extent of the available evidence, and to identify and describe the approaches that have been used to facilitate leisure participation following stroke.Data sourcesEmbase, Medline, PsycINFO, CINAHL, AMED and Cochrane Library were searched between 1989 and June 2026 for studies (quantitative, qualitative and mixed methods) reporting an intervention that addressed leisure and measured the impact on post-stroke leisure participation.Review methodsEstablished scoping review methods guided data extraction with a piloted data charting tool, appraisal utilising Quality Assessment for Diverse Studies (QuADS), and meta-narrative (quantitative findings) and meta-aggregation (qualitative findings) synthesised using a Convergent Segregated Approach.ResultsWe included 28 studies (2588 participants). Most interventions to address leisure participation were face-to-face (93%) and delivered in the community (82%). Interventions were diverse and heterogeneous; however, 8/28 incorporated leisure education/counselling. Quantitative studies reported 12 distinct measures of leisure participation. A positive impact on leisure participation was reported in 13/22 studies reporting quantitative findings and 8/8 studies reporting qualitative findings. Studies were limited by poor reporting of delivery, 'dose' and methodological quality.ConclusionFuture research needs to explore the role of leisure education/counselling, recognise the importance of motivation, social connectedness and hope, and address barriers to leisure participation. Leisure interventions should be co-created with people that have lived experience of stroke. Programme theory, core components of the intervention and delivery methods must be clearly articulated to enable replication. Future studies should capture psychosocial outcomes alongside leisure participation and satisfaction, and assess long-term impact of interventions.