Evaluating the accessibility of exercise referral schemes to stroke survivors in England: A census of local authorities
- 1Lancaster University
Abstract
BackgroundOwing to a growing body of evidence, clinical guidelines now recommend exercise for stroke survivors. However, many stroke survivors are physically inactive and may need more support to engage with exercise in the community. There are between 600-800 exercise referral schemes in the United Kingdom, but engagement from stroke survivors is very low. This study aimed to evaluate the accessibility of exercise referral schemes in England to stroke survivors.
MethodsA cross-sectional, online survey was conducted throughout England. All 317 local authorities in England were invited to participate. Geospatial mapping was used to visualise the accessibility of exercise referral schemes across England. Data on scheme design and delivery parameters were analysed descriptively.
ResultsData were collected from 147 local authorities. Exercise referral schemes were offered in 134 local authorities, of which, stroke survivors were able to access 128. However, stroke-specific schemes were available in only 17 local authorities. Significant variations in exercise referral scheme design and delivery were identified across the country. Only two consistencies were found between schemes: the involvement of fitness instructors, and the lack of transport provision. The capacity of exercise referral schemes did not correlate with the general population, stroke population, or stroke prevalence within a local authority.
ConclusionsExercise referral schemes are widely available across England, and the majority are open to stroke survivors. However, stroke-specific services are very limited and there is substantial variation in scheme eligibility, capacity, costs, and referral pathways. These inconsistencies, paired with the lack of transport provision, may explain the low uptake of exercise referral schemes within the stroke population.
Related
- Evaluating the real-world accessibility of open-source deep learning models for retinal vessel segmentation in optical coherence tomography angiography
- Exercise, inflammation, and fatigue in cancer survivors
- Linear mixed models for evaluating CD4+ count progression and its predictors: a four-year longitudinal study at Yekatit 12 Referral Hospital, Ethiopia
- Association Between Exercise Adherence and Long-Term Quality of Life in Ischemic Stroke Survivors: A 2-Year Prospective Cohort Study.
- Results from a Phase II Single Arm Trial Evaluating the Safety and Efficacy of Anhydrous Enol-Oxaloacetate on Improving Cognitive Complaints in Breast Cancer Survivors
BibTeX
@misc{smith2026evaluating,
title = {{Evaluating the accessibility of exercise referral schemes to stroke survivors in England: A census of local authorities}},
author = {J. Smith and P. Nagy and D. Tod and C. Holland and H. Jarvis},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.21.26363574},
url = {https://www.medrxiv.org/content/10.64898/2026.09.21.26363574v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Evaluating the accessibility of exercise referral schemes to stroke survivors in England: A census of local authorities
AU - J. Smith
AU - P. Nagy
AU - D. Tod
AU - C. Holland
AU - H. Jarvis
PY - 2026
DA - 2026/09/21
PB - medRxiv
DO - 10.64898/2026.09.21.26363574
UR - https://www.medrxiv.org/content/10.64898/2026.09.21.26363574v1
AB - BackgroundOwing to a growing body of evidence, clinical guidelines now recommend exercise for stroke survivors. However, many stroke survivors are physically inactive and may need more support to engage with exercise in the community. There are between 600-800 exercise referral schemes in the United Kingdom, but engagement from stroke survivors is very low. This study aimed to evaluate the accessibility of exercise referral schemes in England to stroke survivors. MethodsA cross-sectional, online survey was conducted throughout England. All 317 local authorities in England were invited to participate. Geospatial mapping was used to visualise the accessibility of exercise referral schemes across England. Data on scheme design and delivery parameters were analysed descriptively. ResultsData were collected from 147 local authorities. Exercise referral schemes were offered in 134 local authorities, of which, stroke survivors were able to access 128. However, stroke-specific schemes were available in only 17 local authorities. Significant variations in exercise referral scheme design and delivery were identified across the country. Only two consistencies were found between schemes: the involvement of fitness instructors, and the lack of transport provision. The capacity of exercise referral schemes did not correlate with the general population, stroke population, or stroke prevalence within a local authority. ConclusionsExercise referral schemes are widely available across England, and the majority are open to stroke survivors. However, stroke-specific services are very limited and there is substantial variation in scheme eligibility, capacity, costs, and referral pathways. These inconsistencies, paired with the lack of transport provision, may explain the low uptake of exercise referral schemes within the stroke population.
ER -