A Systematic Scoping Review of Poststroke Engagement in Physical Activity

Objective

To synthesize knowledge about physical activity engagement in community living stroke survivors.

Data Sources

Six electronic databases (Scopus, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO/PsycARTICLES, and Web of Science) were searched between April 2023 and March 2024. Search parameters were set from database inception to 2024.

Study Selection

Studies were included if they were randomized controlled trials, (quasi)experimental, cross-sectional, or cohort/longitudinal; published in English; focused on measuring or promoting physical activity during rehabilitation or the postrehabilitation phase; and participants were at least 18 years old, living in the community, and had a clinical diagnosis of stroke.

Data Extraction

Data extracted included general study information; study design; participant characteristics; type of physical activity; program characteristics; type of support provided, type of physical activity engagement measure; and engagement outcomes and rates.

Data Synthesis

Twenty-one studies were included in this review; 6 promoted or measured physical activity as part of formal rehabilitation programs and 15 measured physical activity postrehabilitation. More than half of the studies reported low physical activity engagement. Eleven studies used objective measures of physical activity, whereas 8 used subjective measures and 2 used both. Only the 6 formal rehabilitation programs provided additional support for physical activity engagement, but the support was generally not underpinned by motivational theory or evidence. Walking and walk-related tasks were the most promoted type of physical activity poststroke.

Conclusions

We recommend that future interventions provide additional support for engagement that is underpinned by contemporary motivation theory. The type of support offered should differ depending on whether physical activity is part of a formal rehabilitation program or simply encouraged during postrehabilitation.