title: Factors Affecting Attendance at an Adapted Cardiac Rehabilitation Exercise Program for Individuals with Mobility Deficits Poststroke.
abstract: OBJECTIVE
  The aim of this study was to determine the factors affecting attendance at an adapted cardiac rehabilitation program for individuals poststroke.
  
  
  METHODS
  A convenience sample of ambulatory patients with hemiparetic gait rated 20 potential barriers to attendance on a 5-point Likert scale upon completion of a 6-month program of 24 prescheduled weekly sessions. Sociodemographic characteristics, depressive symptoms, cardiovascular fitness, and comorbidities were collected by questionnaire or medical chart.
  
  
  RESULTS
  Sixty-one patients attended 77.3 ± 12% of the classes. The longer the elapsed time from stroke, the lower the attendance rate (r = -.34, P = .02). The 4 greatest barriers influencing attendance were severe weather, transportation problems, health problems, and traveling distance. Health problems included hospital readmissions (n = 6), influenza/colds (n = 6), diabetes and cardiac complications (n = 4), and musculoskeletal issues (n = 2). Of the top 4 barriers, people with lower compared to higher income had greater transportation issues (P = .004). Greater motor deficits of the stroke-affected leg were associated with greater barriers related to health issues (r = .7, P = .001). The only sociodemographic factor associated with a higher total mean barrier score was non-English as the primary language spoken at home (P = .002); this factor was specifically related to the barriers of cost (P = .007), family responsibilities (P = .018), and lack of social support (P = .001). No other associations were observed.
  
  
  CONCLUSIONS
  Barriers to attendance were predominantly related to logistic/transportation and health issues. People who were more disadvantaged socioeconomically (language, finances), and physically (stroke-related deficits) were more affected by these barriers. Strategies to reduce these barriers, including timely referral to exercise programs, need to be investigated.
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada. Electronic address: Susan.marzolini@uhn.ca.
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolini
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Amaris
authors.initials: A
authors.lastname: Balitsky
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada; University of Ontario Institute of Technology, Toronto, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Jagroop
authors.affiliation: Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Corbett
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada; School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Lawrence
authors.affiliation: Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005081:Exercise Therapy / Q000191:economics / Q000523:psychology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation*; D006331:Heart Diseases / Q000453:epidemiology; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D007182:Income; D007802:Language; D008297:Male; D008685:Meteorological Concepts; D008875:Middle Aged; D051346:Mobility Limitation; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010809:Physical Fitness; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications*; D011795:Surveys and Questionnaires; D014195:Travel / Q000191:economics; D014777:Virus Diseases / Q000453:epidemiology; D035862:Vulnerable Populations
keywords: Physical activity; aerobic training; behavior; rehabilitation; resistance training; stroke recovery