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Factors associated with post-stroke physical activity: a systematic review and meta-analysis
Journal article   Peer reviewed

Factors associated with post-stroke physical activity: a systematic review and meta-analysis

Shamala Thilarajah, Benjamin Mentiplay, Kelly Bower, Dawn Tan, Yong-Hao Pua, Gavin Williams, Gerald Koh and Ross Clark
Archives of Physical Medicine and Rehabilitation, Vol.99(9), pp.1876-1889
2018
url
https://doi.org/10.1016/j.apmr.2017.09.117View
Published Version

Abstract

physical activity stroke correlates associations factors
Objective: To integrate the literature investigating factors associated with post-stroke physical activity. Data Sources: A search was conducted from database inception to June 2016 across nine databases: Cochrane, Medline, ProQuest, Web of Science ISI, PsycInfo, Scopus, Embase, CINAHL and AMED. The reference lists of included articles were screened for secondary literature. Study selection: Cohort and cross-sectional studies were included if they recruited community-dwelling stroke survivors and measured factors associated with physical activity. Data Extraction: Risk of bias was evaluated using the Quality in Prognosis Studies checklist. A meta-analysis was conducted for correlates where there were at least two studies that reported a correlation value. Correlation values were used in an effect size measure and converted to a standardised unit with Fisher r to z transformation and conversion back to r method. Results were described qualitatively for studies that could not be pooled. Data Synthesis: 2161 studies were screened and 26 studies were included. Age (meta r=-0.17; p=<0.001) and gender (meta r=-0.01; p=0.02) were the non-modifiable factors that were found to be associated with post-stroke physical activity. The modifiable factors were physical function (meta r=0.68-0.73; p<0.001), cardiorespiratory fitness (meta r=0.35; p=<0.001), fatigue (meta r=-0.22; p=0.01), falls self-efficacy (meta r=-0.33; p<0.001), balance self-efficacy (meta r=0.37; p<0.001), depression (meta r=-0.58-0.48; p<0.001) and health-related quality of life (meta r=0.38-0.43; p<0.001). The impact of side of infarct, neglect and cognition on post-stroke physical activity were inconclusive. Conclusions: Age, gender, physical function, depression, fatigue, self-efficacy and quality of life were factors associated with post-stroke physical activity. The cause and effect of these relationships are unclear and the possibility of reverse causality needs to be addressed.

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