JMIR Publications

ABSTRACT

Background:

Multiple converging lines of evidence confirm a strong association between increased physical activity and positive health outcomes. In the context of stroke prevention and rehabilitation, wearable sensors and companion smartphone applications show promise by facilitating lifestyle modifications and mitigating risk factors. However, interventions leveraging these technologies have demonstrated inconsistent efficacy, particularly with respect to long-term behavioral change.

Objective:

The current study aimed to explore the barriers and facilitators influencing the effective use of PA sensors and applications in older stroke patients and individuals presenting with similar risk factors.

Methods:

This study synthesized primary qualitative research on physical activity sensor use in older stroke patients and those at risk. Due to limited stroke-specific studies, inclusion criteria were expanded to populations with similar risk and deficit profiles. Line-by-line coding of textual data identified overarching themes and analytical constructs.

Results:

A search of six bibliographic databases (January 2010 – December 2023) identified 18 eligible studies. Thematic analysis revealed predominantly technological (user experience and device attributes), and psychological (motivation) barriers. Key facilitators were psychological (feedback, motivation), technological (user experience), and social/environmental supports. Higher-level analysis revealed a critical interrelationship between effective user engagement and optimally assistive device characteristics.

Conclusions:

This review revealed a synergistic user-device interaction driving sustained physical activity in older stroke survivors and those at risk. Future interventions developed in collaboration with patients and informed by the factors identified by the current study will improve participation in rehabilitation and functional outcomes in this population.