Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review.
Peter Hartley, Katie Bond, Rachel Dance and 3 others
PMID 39523528WHAT IT FOUND
After stroke, inpatient activity outside therapy was influenced by staff time, usable ward spaces, family visitors, and rules about moving.
Some supported activity; others kept patients inactive.
Key findings
01Ward environment and resources were the most consistently reported influence, identified in 16 of 17 counted studies.
02Risk-averse ward rules and perceived rules discouraged independent walking, especially because of falls concerns.
03Family and visitors often helped patients walk or exercise, while patients with few visitors had fewer chances to be active.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This review synthesises perceptions and reported influences, not measured effects of any intervention. The reviewers could not always separate physical activity from social or cognitive activity, so some themes may be mixed. Some included papers used the same participants or data, so themes were counted across a maximum of 17 studies. Studies of patients on average more than 12 weeks after stroke, critical care units, non-English papers and conference abstracts were excluded, so it does not cover later recovery, intensive care or international non-English settings. Quality assessment found no significant concerns, but three studies had domains scored as 'can't tell' because reporting was incomplete. The review focused on frequently recognised themes, which may not be the most important influences.
Declared interests
The authors declared no potential conflicts of interest. Funding included Homerton College, University of Cambridge, and the Health Foundation's grant to the University of Cambridge for THIS Institute.
The easy way to misread this
Do not read these themes as proof that adding staff, changing ward spaces or encouraging visitors will increase activity. The review reports influences described by patients, families and staff, not tested interventions.