Physical and Behavioral Barriers to Physical Activity Among Community-Dwelling Stroke Survivors: Preliminary Results

Abstract

Background and Objectives: The level of participation in physical activities (PA) among the Malaysian stroke survivors remains low due to various barriers. This can lead to deconditioning and stroke recurrence. The most common barriers experienced by stroke survivors are patient-related factors, fear of falls, and pandemics. However, past studies primarily relied on generic questionnaires to assess these barriers, resulting in diverse findings. While one study utilized the Barrier to Physical Activity after Stroke Scale (BAPAS), it was conducted outside of Malaysia. Therefore, this study seeks to address this gap by identifying the specific physical and behavioral barriers to PA among community-dwelling stroke survivors in Malaysia. Methods: This prospective cross-sectional study involved 13 community-dwelling stroke survivors with mild to good cognitive ability (MoCA score ≥ 18) at Hospital Jerantut, Pahang. Face-to-face assessments were conducted, during which participants answered sociodemographic questions and completed a validated Malay version of the BAPAS which measured physical and behavioral barriers. Data from completed questionnaires were analyzed using descriptive statistics. Results: The majority of the participants were male, with an average age of 53.15 years and a time range of 10 months to 6 years since stroke diagnosis. Most participants were Malay, residing in urban areas, with a middle-range economic status and secondary education level. The study revealed higher physical barriers, particularly fear of falls and muscle tightness, compared to behavioral barriers. The primary behavioral barriers included concerns about experiencing a second stroke and feelings of excessive fatigue. Conclusion: The study highlights the primary physical and behavioral barriers to PA among community-dwelling stroke survivors in Malaysia. These findings suggest therapists should design customized exercise programs highlighting safety concerns and fatigue when working with stroke survivors. Larger datasets are needed to strengthen these study findings.