A Systematic Scoping Review of Poststroke Engagement in Physical Activity.
Bettina Pasztor, Avril Drummond, Jennie E Hancox and 1 others
PMID 40678284WHAT IT FOUND
Community-dwelling stroke survivors typically walk about 4000 steps a day, falling short of guidelines.
Objective measures show lower activity than self-reports. Interventions with coaching or education increased activity in the short term, but long-term adherence and support quality remain unclear.
Key findings
01Objective measures like accelerometers typically showed lower physical activity levels compared to self-reported measures, with average daily step counts often around 4000 steps.
02Programs providing additional support, such as educational phases, individualized coaching, or motivational interviewing, generally resulted in increased or relatively high physical activity engagement in the short term.
03The additional support provided in these interventions was generally not underpinned by contemporary motivation theory or evidence, limiting understanding of how to sustain long-term engagement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review excluded qualitative studies, missing patient perspectives on barriers and facilitators. Studies were included regardless of quality, and no risk of bias assessment was reported. Only English-language published full-text articles were included, potentially missing grey literature. Most participants had mild motor impairment, so findings may not apply to more severely disabled or non-ambulant stroke survivors. Few studies examined physical activity after the intervention support ended, limiting knowledge on long-term sustainability. There was significant heterogeneity in how physical activity was measured and defined across studies.
Declared interests
The investigators have no financial or nonfinancial disclosures to make in relation to this project.
The easy way to misread this
Do not assume that the short-term increases in physical activity seen in supported interventions will persist after the support ends. The review found that few studies examined long-term adherence, and the support provided was often not grounded in motivation theory, meaning the mechanisms for lasting change are unclear.