Evidence for your practice: How do adults conceptualize physical activity post-stroke?

 

Retrieved from: https://motionarray.com/

How Adults With Stroke Conceptualize Physical Activity: An Exploratory Qualitative Study

Article: Bailey, R. R., & Stevenson, J. L. (2021). How Adults With Stroke Conceptualize Physical Activity: An Exploratory Qualitative Study. American Journal of Occupational Therapy, 75(2), 7502345010p1-7502345010p6.

Physical activity (PA) is recommended for improving physical and cardiovascular function but can be challenging because of stroke-related impairments. A better understanding of how adults with stroke conceptualize PA could assist in developing effective interventions for increasing post-stroke PA. Common stroke-related impairments, among other factors, contribute to increased difficulty engaging in sustained moderate to strenuous PA resulting in as much as 78% of waking hours consisting of sedentary behaviors.  

Methods: Researchers conducted semi-structured interviews with 15 participants to explore how adults with stroke conceptualize PA.

Results: 3 themes emerged:
1) moderate to vigorous PA

• Many participants described PA as exercise, sports and leisure activities that require a certain level of intensity. Other participants didn’t feel they needed to do something strenuous to be considered physically active.

2) PA is necessary for performing daily activities and occupations, which includes basic and instrumental activities of daily living;

• Many participants identified ADLs and IADLs when asked about their conceptualization of PA, and that PA is a necessary component of performing daily activities and occupations. These daily activities ranged from house chores, to shopping, to gardening. 

3) avoiding sedentary behavior, which includes not wanting to sit for long periods of time, avoiding boredom, and valuing PA over being sedentary.

• Most participants spoke about the importance of not sitting too much and avoiding boredom: “Sometimes when I’m bored…instead of just laying around and watching TV, I’ll get up and do something.” 

Conclusion: Conceptualizations of PA can take the form of structured exercise such as going for a walk or a bike ride, or can be integrated into doing house chores or instrumental activities such as cleaning or yard work. PA can also be used by the client as a means of avoiding too much sitting or sedentary behavior and thus remain engaged rather than becoming bored.

Implications for OT: 

• It is important that OTs consider how each client conceptualizes PA in the context of their life and abilities to insure that occupational interventions and goals are planned to suit the client’s needs and wants.

• For some adults with stroke, participation in daily activities may be an acceptable alternative to engaging in intensive PA.

• Occupational therapy practitioners can help clients decrease sedentary behavior and increase non-exercise PA through identification of meaningful activities that require PA.

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