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      The Importance of Psychological and Social Factors in Influencing the Uptake and Maintenance of Physical Activity after Stroke: A Structured Review of the Empirical Literature

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          Abstract

          Background. People with stroke are not maintaining adequate engagement in physical activity (PA) for health and functional benefit. This paper sought to describe any psychological and social factors that may influence physical activity engagement after stroke. Methods. A structured literature review of studies indexed in MEDLINE, CinAHL, P&BSC, and PsycINFO using search terms relevant to stroke, physical disabilities, and PA. Publications reporting empirical findings (quantitative or qualitative) regarding psychological and/or social factors were included. Results. Twenty studies from 19 publications (9 surveys, 1 RCT, and 10 qualitative studies) were included. Seventeen studies reported findings pertinent to psychological factors and fourteen findings pertinent to social factors. Conclusion. Self-efficacy, physical activity beliefs, and social support appear particularly relevant to physical activity behaviour after stroke and should be included in theoretically based physical interventions. The Transtheoretical Model and the Theory of Planned Behaviour are candidate behavioural models that may support intervention development.

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          Most cited references69

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          Self-determination theory: A macrotheory of human motivation, development, and health.

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            Transtheoretical therapy: Toward a more integrative model of change.

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              Physical activity participation among persons with disabilities: barriers and facilitators.

              The purpose of this study was to identify various barriers and facilitators associated with participation in fitness and recreation programs/facilities among persons with disabilities. Focus groups were conducted in ten regions across the United States in 2001 to 2002 with four types of participants: (1) consumers with disabilities, (2) architects, (3) fitness and recreation professionals, and (4) city planners and park district managers. Sessions were tape-recorded and content analyzed; focus group facilitators took notes of identified barriers and facilitators to access. Content analysis of tape recordings revealed 178 barriers and 130 facilitators. The following themes were identified: (1) barriers and facilitators related to the built and natural environment; (2) economic issues; (3) emotional and psychological barriers; (4) equipment barriers; (5) barriers related to the use and interpretation of guidelines, codes, regulations, and laws; (6) information-related barriers; (7) professional knowledge, education, and training issues; (8) perceptions and attitudes of persons who are not disabled, including professionals; (9) policies and procedures both at the facility and community level; and (10) availability of resources. The degree of participation in physical activity among people with disabilities is affected by a multifactorial set of barriers and facilitators that are unique to this population. Future research should utilize this information to develop intervention strategies that have a greater likelihood of success.
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                Author and article information

                Journal
                Stroke Res Treat
                SRT
                Stroke Research and Treatment
                Hindawi Publishing Corporation
                2090-8105
                2042-0056
                2012
                11 September 2011
                : 2012
                : 195249
                Affiliations
                1School of Nursing and Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK
                2Social Dimensions of Health Institute, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK
                Author notes

                Academic Editor: Julie A. Bernhardt

                Article
                10.1155/2012/195249
                3170904
                21918730
                80bd5256-75af-43b8-8fcc-2aa76f4a122d
                Copyright © 2012 Jacqui Morris et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 June 2011
                : 12 July 2011
                Categories
                Review Article

                Cardiovascular Medicine
                Cardiovascular Medicine

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