What’s keeping people after stroke from walking outdoors to become physically active A qualitative study, using an integrated biomedical and behavioral theory of functioning and disabilityReportar como inadecuado




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BMC Neurology

, 16:137

Cerebrovascular disease and stroke

Abstract

BackgroundIn general people after stroke do not meet the recommendations for physical activity to conduct a healthy lifestyle. Programs to stimulate walking activity to increase physical activity are based on the available insights into barriers and facilitators to physical activity after stroke. However, these programs are not entirely successful. The purpose of this study was to comprehensively explore perceived barriers and facilitators to outdoor walking using a model of integrated biomedical and behavioral theory, the Physical Activity for people with a Disability model PAD.

MethodsIncluded were community dwelling respondents after stroke, classified ≥ 3 at the Functional Ambulation Categories FAC, purposively sampled regarding the use of healthcare. The data was collected triangulating in a multi-methods approach, i.e. semi-structured, structured and focus-group interviews. A primarily deductive thematic content analysis using the PAD-model in a framework-analysis’ approach was conducted after verbatim transcription.

Results36 respondents FAC 3–5 participated in 16 semi-structured interviews, eight structured interviews and two focus-group interviews. The data from the interviews covered all domains of the PAD model. Intention, ability and opportunity determined outdoor walking activity. Personal factors determined the intention to walk outdoors, e.g. negative social influence, resulting from restrictive caregivers in the social environment, low self-efficacy influenced by physical environment, and also negative attitude towards physical activity. Walking ability was influenced by loss of balance and reduced walking distance and by impairments of motor control, cognition and aerobic capacity as well as fatigue. Opportunities arising from household responsibilities and lively social constructs facilitated outdoor walking.

ConclusionTo stimulate outdoor walking activity, it seems important to influence the intention by addressing social influence, self-efficacy and attitude towards physical activity in the development of efficient interventions. At the same time, improvement of walking ability and creation of opportunity should be considered.

KeywordsStroke Community ambulation Outdoor walking Physical activity  Download fulltext PDF



Autor: Jacqueline Outermans - Jan Pool - Ingrid van de Port - Japie Bakers - Harriet Wittink

Fuente: https://link.springer.com/







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