Impact of pandemic on compliance to physical activity program among Indian community-dwelling stroke survivors: a qualitative study

We aimed to explore the factors influencing compliance with individualized physical activity programs among community-dwelling stroke survivors during and after the COVID-19 pandemic.

We recruited fifteen community-dwelling stroke survivors who had completed a physical activity program conducted over a period of six weeks. The program included stroke participants who were of the age range 18-75 years, medically stable, functional cognition and communication ability, had a post-stroke duration of more than 6 months, were able to walk independently with or without an assistive device, and were living in the community. We developed a interview guide and validated it for the use of telephonic interview. We conducted a  telephonic, semi-structured interviews among the participants.  These interviews were conducted at 9 and 12 months, during and after the lockdown respectively, after the completion of the physical activity program. The duration of each interview lasted around 30 minutes. We have analyzed qualitative data through a content analysis approach.

Thirteen of the fifteen participants complied with the physical activities prescribed. Perceived improvements, motivation and confidence, supportive family were the general factors and plenty of free time and ease of community ambulation due to less traffic were the major factors of compliance during the pandemic. The general factor for non-compliance were feeling of depression, lack of interest while feeling of sadness, loneliness and boredom along with  limited access to physiotherapists were pandemic specific due to the lockdown.

Though the pandemic had limited physical activity in general, the comprehensive physical activity program had helped stroke survivors remain active. The majority of the participants were compliant to the individualized physical activity program at long-term follow-up. Various factors for compliance and non-compliance were identified through this study.

Factors identified for compliance in this study should be addressed while developing interventions for physical activity among community-dwelling stroke survivors.