- 作者：Susan Marzolini ; PhD* ; Susan.marzolini@uhn.ca" class="auth_mail" title="E-mail the corresponding author ; Amaris Balitsky ; MD&dagger ; ; David Jagroop ; BHSc* ; &Dagger ; ; Dale Corbett ; PhD§ ; ; ‖ ; Dina Brooks ; PhD* ; § ; ; ¶ ; ; Sherry L. Grace ; PhD* ; # ; Danielle Lawrence ; BHSc.Kin* ; Paul I. Oh ; MD* ; § ;
- 关键词：Physical activity ; stroke recovery ; behavior ; aerobic training ; resistance training ; rehabilitation
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2016
- 出版时间：January 2016
- 年：2016
- 卷：25
- 期：1
- 页码：87-94
- 全文大小：137 K
Methods
A convenience sample of ambulatory patients with hemiparetic gait rated 20 potential barriers to attendance on a 5-point Likert scale upon completion of a 6-month program of 24 prescheduled weekly sessions. Sociodemographic characteristics, depressive symptoms, cardiovascular fitness, and comorbidities were collected by questionnaire or medical chart.
Results
Sixty-one patients attended 77.3 ± 12% of the classes. The longer the elapsed time from stroke, the lower the attendance rate (r = −.34, P = .02). The 4 greatest barriers influencing attendance were severe weather, transportation problems, health problems, and traveling distance. Health problems included hospital readmissions (n = 6), influenza/colds (n = 6), diabetes and cardiac complications (n = 4), and musculoskeletal issues (n = 2). Of the top 4 barriers, people with lower compared to higher income had greater transportation issues (P = .004). Greater motor deficits of the stroke-affected leg were associated with greater barriers related to health issues (r = .7, P = .001). The only sociodemographic factor associated with a higher total mean barrier score was non-English as the primary language spoken at home (P = .002); this factor was specifically related to the barriers of cost (P = .007), family responsibilities (P = .018), and lack of social support (P = .001). No other associations were observed.
Conclusion
Barriers to attendance were predominantly related to logistic/transportation and health issues. People who were more disadvantaged socioeconomically (language, finances), and physically (stroke-related deficits) were more affected by these barriers. Strategies to reduce these barriers, including timely referral to exercise programs, need to be investigated.