Journal
DISABILITY AND REHABILITATION
Volume 43, Issue 17, Pages 2382-2396Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2019.1704075
Keywords
Stroke; exercise; rehabilitation; implementation; Attitude of Health Personnel*; Health Knowledge; Attitudes; Practice; systematic review
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Funding
- Chartered Society of Physiotherapy Charitable Trust [PRF/17/B01]
- Chartered Society of Physiotherapy Charitable Trust [PRF/17/B01] Funding Source: researchfish
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This systematic review explored factors affecting the implementation of aerobic exercise after stroke, including professionals' self-efficacy and knowledge, patients' needs, communication and collaboration within organizations, and resources. Strategies should target these modifiable factors to facilitate aerobic exercise implementation.
Objectives: This systematic review aimed to explore the perspectives of healthcare, exercise, and fitness professionals working with people post-stroke regarding the factors affecting the implementation of aerobic exercise after stroke. Data Sources: OVID SP MEDLINE, OVID SP EMBASE, and CINAHL were searched from inception to December 2018 using a combination of search terms with synonyms of stroke, aerobic exercise and barriers/facilitators. Review methods: Studies focusing on the factors affecting implementation of aerobic exercise after stroke from staff perspectives were included with no restriction on the types of study design. For inclusivity, a broad definition of aerobic exercise was used. Review authors independently extracted data from included studies using domains from the Consolidated Framework for Implementation Research, then synthesised using a framework synthesis approach. Retrospective automated screening was conducted using Rayyan software. Results: Twenty studies were included. Four reported on implementation of aerobic exercise, sixteen on general exercise interventions, all post-stroke. Factors identified as influencing implementation of aerobic exercise after stroke included professionals' self-efficacy and knowledge about stroke, patients' needs, communication and collaboration within and between organisations and resources such as equipment, staff and training. Conclusions: Key factors influencing the implementation of aerobic exercise after stroke included characteristics of the staff and intervention and system-level issues, some of which are modifiable. Further research should evaluate strategies which specifically target these modifiable factors to facilitate implementation in practice.
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