Global Account of Barriers and Facilitators of Physical Activity Among Patients with Diabetes Mellitus: A Narrative Review of the Literature.
BACKGROUND
With diabetes rates escalating globally, there is the need for a better integration of all aspects of diabetes care for improved population outcomes. An understanding, not only of regional but global literature on physical activity barriers and its facilitators is important if healthcare providers and policy makers are to create programs tailored to their populations.


OBJECTIVE
Herein, we report the results of a narrative review of the global barriers and facilitators of physical activity for patients with diabetes mellitus.


METHODS
An in-depth literature search was conducted to identify English-language studies that examined physical activity barriers and associated facilitators among patients with diabetes mellitus. Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire.


RESULTS
Studies were available from Africa, Asia, Australia, Europe, and, predominantly North America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported were time constrains, fear of provoking additional disorders, exercise venue and weather related barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g. time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution etc) received only a minimal attention.


CONCLUSIONS
Globally, patients with diabetes are confronted with an enormous number of physical activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely silent about solutions to the external barriers, which though fewer, may be highly influential. Additional data is needed to better understand physical activity behaviors in populations outside of North America.
Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria. adeniyifatai@yahoo.co.uk.
Ade F
AF
Adeniyi
Ranjit M
RM
Anjana
Mary B
MB
Weber
D003144:Communication Barriers; D003469:Culture; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy*; D015444:Exercise / Q000523:psychology; D005843:Geography; D014943:Global Health; D006801:Humans; D019359:Knowledge; D008019:Life Style