Nicholson Sarah L, Donaghy Marie, Johnston Marie, Sniehotta Falko F, van Wijck Frederike, Johnston Derek, Greig Carolyn, McMurdo Marion E T, Mead Gillian
School of Clinical Sciences and Community Health, The University of Edinburgh , Edinburgh , UK .
Disabil Rehabil. 2014;36(22):1857-68. doi: 10.3109/09638288.2013.874506. Epub 2013 Dec 31.
After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity.
Semi-structured interviews with 13 ambulatory stroke survivors exploring perceived barriers and facilitators to physical activity post stroke were conducted in participants' homes, audio-recorded and transcribed verbatim. The Theoretical Domains Framework (TDF) informed content analysis of the interview transcripts.
Data saturation was reached after interviews with 13 participants (median age of 76 years (inter-quartile range (IQR) = 69-83 years). The median time since stroke was 345 d (IQR = 316-366 d). The most commonly reported TDF domains were "beliefs about capabilities", "environmental context and resources" and "social influence". The most commonly reported perceived motivators were: social interaction, beliefs of benefits of exercise, high self-efficacy and the necessity of routine behaviours. The most commonly reported perceived barriers were: lack of professional support on discharge from hospital and follow-up, transport issues to structured classes/interventions, lack of control and negative affect.
Stroke survivors perceive several different barriers and facilitators to physical activity. Stroke services need to address barriers to physical activity and to build on facilitators to promote physical activity after stroke.
Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental context and resources and social influences were the mostly commonly report influences on stroke survivors' perceived barriers and facilitators to physical activity.
中风后，身体活动和体能水平较低，对健康、活动及参与产生影响。目前尚不清楚如何以最佳方式支持中风幸存者增加身体活动。对于中风后身体活动的障碍和促进因素知之甚少。因此，我们的目的是探讨中风幸存者对身体活动的感知障碍和促进因素。
对13名能行走的中风幸存者进行了半结构化访谈，在参与者家中探讨中风后身体活动的感知障碍和促进因素，进行了音频录制并逐字转录。理论领域框架（TDF）为访谈记录的内容分析提供了依据。
在对13名参与者（中位年龄76岁（四分位间距（IQR）=69 - 83岁））进行访谈后达到了数据饱和。中风后的中位时间为345天（IQR = 316 - 366天）。最常报告的TDF领域是“对能力的信念”、“环境背景和资源”以及“社会影响”。最常报告的感知激励因素是：社交互动、对运动益处的信念、高自我效能感以及日常行为的必要性。最常报告的感知障碍是：出院和随访时缺乏专业支持、前往结构化课程/干预的交通问题、缺乏控制感和负面影响。
中风幸存者感知到身体活动存在多种不同的障碍和促进因素。中风服务需要解决身体活动的障碍，并利用促进因素来推动中风后的身体活动。
中风后的身体活动可以改善体能和功能，但中风幸存者的身体活动水平仍然较低。了解中风幸存者对身体活动的感知障碍和促进因素对于制定有针对性的干预措施以增加身体活动至关重要。对能力的信念、环境背景和资源以及社会影响是最常报告的对中风幸存者身体活动感知障碍和促进因素的影响。
