Factors associated with exercise adherence among stroke survivors: a cross-sectional study using the COM-B model

/df = 2.097 < 3, RMSEA = 0.055, SRMR = 0.0376, CFI = 0.979, TLI = 0.974, IFI = 0.980, GFI = 0.933, AGFI = 0.902, and NFI = 0.951). Direct path analyses revealed that psychological resilience (β = 0.174, p < 0.01), social support (β = 0.184, p < 0.01), and rehabilitation motivation (β = 0.517, p < 0.001) significantly affected exercise adherence. Furthermore, both psychological resilience (β = 0.142, p < 0.001) and social support (β = 0.218, p < 0.001) exerted indirect effects on exercise adherence through their impact on rehabilitation motivation. Enhancing exercise adherence among stroke survivors requires attention to psychological resilience, social support, and particularly, rehabilitation motivation. The mediating influence of rehabilitation motivation in linking psychological resilience and social support to adherence is especially noteworthy. Interventions targeting these factors may effectively improve exercise adherence and optimize post-stroke recovery outcomes.