Stroke survivor and caregiver perspectives in the development of a community water-based therapeutic exercise program.

Background: Water-based therapeutic exercise (WBTE) is an effective approach for stroke survivors to regain strength, mobility, and quality of life. However, existing trials have not included stroke survivors' perspectives in intervention development, which are critical to ensure a WBTE program meets the needs of stroke survivors and provides supports to enable engagement in ongoing exercise.

Methods: Qualitative semi-structured interviews were completed with stroke survivors and caregivers with the aim to have them (1) provide feedback on elements of the intervention resulting from a preceding scoping review and (2) identify barriers, facilitators and other considerations that may impact implementation. Literature on the development of complex health interventions and implementation science informed interview topics. Interviews were analyzed using generic coding and thematic analysis for open-ended and closed-ended questions, respectively.

Results: Stroke survivor and caregivers largely confirmed findings from the scoping review regarding intervention characteristics. Four main considerations for implementation were identified in interview analysis: (1) safety, (2) knowledge and beliefs, (3) environment, and (4) individual characteristics.

Conclusion: It is essential to consider stroke survivor and caregiver perspectives when developing interventions to promote ongoing exercise following formal rehabilitation. The unique needs of each stroke survivor should be evaluated to optimize participation in WBTE.