The relationship between levels of physical activity and participation in everyday life in stroke survivors: A systematic review and meta-analysis
Cristina de Diego-Alonso, Pablo Bellosta‐López, Julia Blasco-Abadía, Almudena Buesa-Estéllez, Patricia Roldán-Pérez, Almudena Medina‐Rincón, María Pilar López-Royo, Rafael Giner-Nicolás, Victor Doménech‐García, Natalie A. Fini
Abstract
Stroke survivors demonstrate decreased physical activity (PA) and take time to return to participation in everyday life, but the relationship between the two variables is unknown. To investigate the correlation and trajectory over time between levels of PA and participation in everyday life in stroke survivors. PubMed, Web of Science, Scopus, SPORTDiscus, Rehabilitation&Sport Medicine Source, and PEDro databases were searched from inception to January 2024. Cross-sectional and prospective studies evaluating both levels of PA and participation in stroke survivors were included. Two reviewers independently conducted the study selection, data extraction, and quality assessment. Meta-analyses of pooled correlation coefficients were calculated when at least two studies reported a correlation coefficient between the same PA and participation outcomes. Of 4,962 studies identified, 49 were included in the systematic review. Studies were rated high (55%%) or fair (45%) quality. A wide range of monitoring methodologies for assessing PA and participation were found in the 23 prospective studies. Seven studies were included in the meta-analyses, showing a positive moderate correlation between PA time and participation in activities of daily living (n=148; r=0.52; P<0.01; I2=81%) in participants <6 months post-stroke, and between PA time and the participation in all areas (n=126; r=0.44; P<0.01; I2=0%) in participants ≥6 months post-stroke. Overall, while PA showed significant improvements over time, participation only showed a tendency. Despite the heterogeneity, consistent positive associations were found between PA time and participation levels in some areas. Establishing consensus is crucial to reduce heterogeneity and facilitate data pooling.