Factors Associated With Post-Stroke Physical Activity: A Systematic Review and Meta-Analysis

Abstract 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 9 databases: Cochrane, MEDLINE, ProQuest, Web of Science, PsycINFO, Scopus, Embase, CINAHL, and Allied and Complementary Medicine Database. 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 2 studies that reported a correlation value. Correlation values were used in an effect size measure and converted to a standardized 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 There were 2161 studies screened and 26 studies included. Age (meta r =−.17; P ≤.001) and sex (meta r =−.01; P =.02) were the nonmodifiable factors that were found to be associated with post-stroke physical activity. The modifiable factors were physical function (meta r =.68–.73; P r =.35; P ≤.001), fatigue (meta r =−.22; P =.01), falls self-efficacy (meta r =−.33; P r =.37; P r =−.58 to .48; P r =.38–.43; P Conclusions Age, sex, physical function, depression, fatigue, self-efficacy, and quality of life were factors associated with post-stroke physical activity. The cause and effect of these relations are unclear, and the possibility of reverse causality needs to be addressed.