Stroke survivors with limited walking ability have unique barriers and facilitators to physical activity

Stroke is a leading cause of morbidity and mortality in Canada. Approximately 73% of stroke survivors experience limited walking ability, requiring a gait aid or assistance. Physical activity is important for secondary stroke prevention, in addition to its benefits for physical and mental health. Little is known about the barriers and facilitators to physical activity in stroke survivors with limited walking ability. This qualitative study used inductive thematic analysis of structured interviews to explore the barriers and facilitators to physical activity in stroke survivors with limited walking ability. Perceived barriers to physical activity included scarcity of services, societal views, changes in ability, and inclement weather. Perceived facilitators included the desired benefits of physical activity, multidisciplinary rehabilitation services, durable medical equipment, encouragement, positive mindset, and self-efficacy. Improving access to rehabilitation services in the chronic phase of stroke and increasing the availability of structured exercise programmes are important strategies to address barriers to physical activity in this population. Supporting self-efficacy, addressing disability stigma, and policy changes are also needed to facilitate participation. Stroke rehabilitation programmes should prioritize education about exercise and adaptation strategies to improve self-efficacy and facilitate ongoing physical activity outside of structured settings.Rehabilitation teams should emphasize the benefits of physical activity for mental and physical health, as well as secondary stroke prevention, to enhance motivation and adherence to physical activity recommendations.Rehabilitation professionals should advocate for increased access to multidisciplinary services, including physical therapy, orthotics, and physiatry, to address physical impairments and activity limitations that hinder physical activity participation.Rehabilitation professionals should consider the impact of societal views and stigma when developing strategies to increase physical activity in stroke survivors with limited walking ability. Stroke rehabilitation programmes should prioritize education about exercise and adaptation strategies to improve self-efficacy and facilitate ongoing physical activity outside of structured settings. Rehabilitation teams should emphasize the benefits of physical activity for mental and physical health, as well as secondary stroke prevention, to enhance motivation and adherence to physical activity recommendations. Rehabilitation professionals should advocate for increased access to multidisciplinary services, including physical therapy, orthotics, and physiatry, to address physical impairments and activity limitations that hinder physical activity participation. Rehabilitation professionals should consider the impact of societal views and stigma when developing strategies to increase physical activity in stroke survivors with limited walking ability.