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Barriers and Facilitators to Aerobic Exercise Implementation in Stroke Rehabilitation: A Scoping Review
Journal of Neurologic Physical Therapy ( IF 2.6 ) Pub Date : 2020-07-01 , DOI: 10.1097/npt.0000000000000318
Kevin Moncion , Louis Biasin , David Jagroop , Mark Bayley , Cynthia Danells , Avril Mansfield , Nancy M. Salbach , Elizabeth Inness , Ada Tang

Supplemental Digital Content is Available in the Text. Background and Purpose: Aerobic exercise is a recommended part of stroke best practices; yet, access to aerobic exercise programs within stroke rehabilitation remains limited and inconsistent. The purpose of this scoping review was to describe the nature and extent of barriers and facilitators to aerobic exercise implementation with adults post-stroke as reported by health care professionals. Methods: MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, and AMED Allied and Complementary Medicine were searched from inception to October 16, 2019. Research studies that examined health care professionals' barriers and facilitators to aerobic exercise implementation in adults post-stroke were included. Two reviewers independently conducted title and abstract screening, full-text evaluation, data extraction, and quality appraisal. The Theoretical Domains Framework was used to map the identified barriers or facilitators and to analyze and interpret the results. Results: Four studies were included in the review. All studies involved surveys conducted among physical therapists and reported barriers related to “environmental context and resources” (eg, lack of equipment, time, staff), insufficient “knowledge” and “skills” (eg, safe aerobic exercise prescription and implementation), “beliefs about capabilities” (eg, uncertainty about exercise intensity and screening tools), and professional role and identity (eg, aerobic exercise not a priority). Access to and continued education in structured aerobic exercise programs and safety monitoring were identified facilitators. Discussion and Conclusions: Some of the identified barriers could be overcome with modeling and training in best practice, while others may require interventions targeting organizational environment and leadership. Future knowledge translation interventions should target the identified barriers and facilitators to implementing aerobic exercise. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A312).

中文翻译:

在中风康复中实施有氧运动的障碍和促进因素:范围审查

补充数字内容在文本中可用。背景和目的:有氧运动是推荐的中风最佳实践的一部分;然而,在中风康复中获得有氧运动计划的机会仍然有限且不一致。本范围界定审查的目的是描述医疗保健专业人员报告的成人卒中后有氧运动实施的障碍和促进因素的性质和程度。方法:从成立到 2019 年 10 月 16 日,对 MEDLINE、EMBASE、Web of Science、CINAHL、PsycINFO 和 AMED Allied and Complementary Medicine 进行了搜索。被包括在内。两位审稿人独立进行标题和摘要筛选,全文评价,数据提取和质量评估。理论领域框架用于绘制已识别的障碍或促进因素,并分析和解释结果。结果:该评价包括四项研究。所有研究都涉及在物理治疗师中进行的调查,并报告了与“环境背景和资源”(例如,缺乏设备、时间、人员)、“知识”和“技能”不足(例如,安全的有氧运动处方和实施)相关的障碍, “对能力的信念”(例如,对运动强度和筛选工具的不确定性),以及专业角色和身份(例如,有氧运动不是优先事项)。确定了促进结构化有氧运动计划和安全监测的获取和继续教育。讨论和结论:一些已确定的障碍可以通过最佳实践中的建模和培训来克服,而其他障碍可能需要针对组织环境和领导力的干预措施。未来的知识转化干预措施应针对已识别的障碍和促进有氧运动的因素。视频摘要可提供作者的更多见解(参见视频,补充数字内容 1,http://links.lww.com/JNPT/A312)。
更新日期:2020-07-01
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