Barriers and facilitators to reducing sedentary behaviour in stroke survivors: a scoping review based on the theoretical domains framework.

OBJECTIVES

To synthesise barriers and facilitators to reducing sedentary behaviour among stroke survivors and map them to the Theoretical Domains Framework (TDF).

DESIGN

A scoping review conducted following Joanna Briggs Institute (JBI) methodology and reported in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis, Scoping Review extension (PRISMA-ScR) guidelines.

DATA SOURCES

Nine electronic databases (PubMed, CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, CNKI and WanFang) were searched from inception to May 2025. Grey literature was identified through Google Scholar and ProQuest. Updated research was conducted in July 2026.

ELIGIBILITY CRITERIA

Studies focusing on barriers and/or facilitators to sedentary behaviour among stroke survivors were included, with no restrictions on study design.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently screened studies, extracted data and mapped identified barriers and facilitators to the Theoretical Domains Framework. Frequencies of domains were calculated to summarise distribution patterns.

RESULTS

49 studies were included. A total of 32 barriers and 17 facilitators were identified and mapped to 12 TDF domains. Barriers were reported more frequently than facilitators. The most frequently represented domains included Skills, Environmental Context and Resources, Beliefs about Capabilities, Beliefs about Consequences, Social Influences, Knowledge and Emotion. Common barriers included stroke-related physical and functional limitations, fatigue, inadequate knowledge, low self-efficacy, fear of falling, limited social support and environmental constraints. Key facilitators included sedentary behaviour education, higher self-efficacy, supportive social and physical environments, inpatient rehabilitation and behaviour change strategies that promoted more active lifestyles.

CONCLUSIONS

Barriers to reducing sedentary behaviour among stroke survivors include limited knowledge, low motivation, insufficient social support, negative emotions and beliefs and physical limitations. Facilitators include social support, positive beliefs and supportive environmental conditions. Future interventions should comprehensively address these multilevel factors to develop more tailored and feasible behaviour change strategies.

REGISTRATION NUMBER

This study was registered with the Open Science Framework website (osf.io/ma8qp).

© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.