Perceived barriers to exercise reported by individuals with stroke, who are able to walk in the community

Abstract

Purpose

To identify the perceived barriers to exercise, which could be modified, as well as the associated factors in people at the sub-acute post-stroke stages, who were able to walk in the community.

Methods

For this exploratory study, barriers to exercise were identified by the Exercise Barrier sub-scale of the Exercise Benefits/Barriers Scale. Step-wise multiple linear regression analysis was employed to identify which of the clinical and sociodemographic variables, that is, age, walking speed, levels of physical activity, socioeconomic status, and depressive symptoms, could significantly predict the Exercise Barrier sub-scale scores.

Results

Ninety-five individuals, who had a mean age of 63 (13) years and a mean time since the onset of the stroke of 4 (1) months participated. The main reported barriers to exercise were related to fatigue, as well as availability and distance from the exercise places. Additional reported barriers were “lack of a person to help” and “knowledge on how to practice exercise.” Perceived barriers were associated with depressive symptoms and socioeconomic status. Together, they explained 9% of the variance in the Exercise Barrier sub-scale scores (p < 0.01).

Conclusions

Fatigue, reduced number of places, and long distances to exercise places were the main reported barriers to exercise. Depressive symptoms and socioeconomic status were the only variables that explained the variance in the Exercise Barrier sub-scale scores. Rehabilitation interventions should include strategies to reduce fatigue during and after exercise, provide guidance regarding both structured and unstructured exercise venues, in addition to screening and managing depressive symptoms.

Implications for Rehabilitation

• Stroke survivors, who are able to walk in the community, should be referred and instructed on how to reduce fatigue through the practice of exercise.

• Health professionals should guide stroke survivors about the existing places for practice of exercise and how to exercise without structured environments.

• It is necessary to create or reformulate environments for exercise and provide orientation to practice through qualified professionals.

• Health professionals should also be able to assess the presence of depressive symptoms and address proper referral and management of the potential barriers to exercise.

Keywords:

• Stroke
• barriers
• exercise
• physical activity
• rehabilitation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Brazilian Government Funding Agencies: CAPES (code 001), CNPq (PIBIC 04/2018), and FAPEMIG (PROBIC 05/2017) for the financial support. Risoleta Tolentino Neves Hospital, MG. - Brazil for the data collection support.