Patient factors influencing participation in aerobic exercise during inpatient and outpatient rehabilitation post stroke: a prospective cohort study
- 1University Health Network
Abstract
BackgroundAerobic exercise is recommended during stroke rehabilitation to improve cardiorespiratory fitness and support recovery; however, participation rates remain low. While institutional and system-level barriers have been widely examined, less is known about how individual patient factors influence engagement in aerobic exercise during rehabilitation.
ObjectivesWe aimed to determine whether depressive symptoms, apathy, self{square}efficacy and outcome expectations for exercise, perceived barriers, or past exercise history were associated with aerobic exercise participation in stroke rehabilitation.
MethodsIn this prospective cohort sub{square}study, adults admitted to in- or out-patient stroke rehabilitation at three urban hospitals completed validated questionnaires assessing depressive symptoms, apathy, exercise self{square}efficacy, outcome expectations for exercise, perceived barriers to being active, and premorbid exercise history. Participants were separated into two groups for analysis: those who completed aerobic exercise during rehabilitation and those who did not. Equivalence testing and between{square}group comparisons were performed.
ResultsSixty{square}two participants were enrolled; 16 participated in aerobic exercise and 46 did not. Groups were not equivalent on any individual{square}level factors. Compared to non{square}participants, those who performed aerobic exercise had significantly higher depressive symptom scores (p=0.0025) and lower self{square}efficacy for exercise (p=0.0087). Non{square}participants demonstrated significantly higher apathy (p=0.0007). No significant differences were found for outcome expectations, perceived barriers, or exercise history.
ConclusionDepressive symptoms and lower self{square}efficacy did not impede aerobic exercise participation during rehabilitation. Increased apathy, however, was associated with non{square}participation. Findings highlight the need for individually tailored aerobic exercise prescriptions that consider motivational and affective factors to optimize engagement during stroke rehabilitation.
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BibTeX
@misc{barzideh2026patient,
title = {{Patient factors influencing participation in aerobic exercise during inpatient and outpatient rehabilitation post stroke: a prospective cohort study}},
author = {A. Barzideh and A. J. Devasahayam and S. Marzolini and S. Munce and K. M. Sibley and E. L. Inness and A. Mansfield},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.26.26361451},
url = {https://www.medrxiv.org/content/10.64898/2026.08.26.26361451v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Patient factors influencing participation in aerobic exercise during inpatient and outpatient rehabilitation post stroke: a prospective cohort study
AU - A. Barzideh
AU - A. J. Devasahayam
AU - S. Marzolini
AU - S. Munce
AU - K. M. Sibley
AU - E. L. Inness
AU - A. Mansfield
PY - 2026
DA - 2026/08/26
PB - medRxiv
DO - 10.64898/2026.08.26.26361451
UR - https://www.medrxiv.org/content/10.64898/2026.08.26.26361451v1
AB - BackgroundAerobic exercise is recommended during stroke rehabilitation to improve cardiorespiratory fitness and support recovery; however, participation rates remain low. While institutional and system-level barriers have been widely examined, less is known about how individual patient factors influence engagement in aerobic exercise during rehabilitation. ObjectivesWe aimed to determine whether depressive symptoms, apathy, self{square}efficacy and outcome expectations for exercise, perceived barriers, or past exercise history were associated with aerobic exercise participation in stroke rehabilitation. MethodsIn this prospective cohort sub{square}study, adults admitted to in- or out-patient stroke rehabilitation at three urban hospitals completed validated questionnaires assessing depressive symptoms, apathy, exercise self{square}efficacy, outcome expectations for exercise, perceived barriers to being active, and premorbid exercise history. Participants were separated into two groups for analysis: those who completed aerobic exercise during rehabilitation and those who did not. Equivalence testing and between{square}group comparisons were performed. ResultsSixty{square}two participants were enrolled; 16 participated in aerobic exercise and 46 did not. Groups were not equivalent on any individual{square}level factors. Compared to non{square}participants, those who performed aerobic exercise had significantly higher depressive symptom scores (p=0.0025) and lower self{square}efficacy for exercise (p=0.0087). Non{square}participants demonstrated significantly higher apathy (p=0.0007). No significant differences were found for outcome expectations, perceived barriers, or exercise history. ConclusionDepressive symptoms and lower self{square}efficacy did not impede aerobic exercise participation during rehabilitation. Increased apathy, however, was associated with non{square}participation. Findings highlight the need for individually tailored aerobic exercise prescriptions that consider motivational and affective factors to optimize engagement during stroke rehabilitation.
ER -