Barriers, facilitators and promising interventions for reducing sedentary behaviour during and after stroke rehabilitation - A scoping review.

Abstract

Reducing sedentary behaviour (SB) in stroke rehabilitation is essential, yet effects of most interventions remain limited. This review used the Behaviour Change Wheel to identify: (1) barriers and facilitators for reducing SB of stroke survivors and (2) Behaviour Change Techniques (BCTs) incorporated in "promising" interventions. Seven databases were searched from inception to January 2025. Data were systematically extracted and coded using the Capacity Opportunity Motivation - Behaviour model (COM‑B) and the Theoretical Domains Framework (TDF). Thirty-nine studies on barriers and facilitators were included, identifying 32 different barriers and 30 facilitators in inpatient settings and 109 barriers and 73 facilitators in outpatient/community settings, spanning all COM-B domains. Four of seven interventions were rated as "promising" (predefined criterion: statistically significant changes within or between group(s)). These interventions applied 11-34 BCTs, including goal setting, action planning, reviewing goals, feedback, social support, instruction, and demonstration. Given the variety of barriers and facilitators experienced, personalised approaches are essential. Promising interventions share components that can inform SB‑focused intervention design, but further research is needed to determine how these components can be combined and tailored to support sustained SB reduction.