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Factors associated with exercise adherence among stroke survivors: a cross-sectional study using the COM-B model
Minjuan Wu1, Wenqin Wang1, Hongmei He2
1School of Medicine, Quzhou College of Technology, No. 18 Jiangyuan Road, Baiyun Street, Kecheng District, Quzhou, 324000, Zhejiang Province, China.
Scientific Reports
|May 12, 2026
Summary
Exercise adherence is crucial for stroke survivors, but often low. This study found psychological resilience, social support, and rehabilitation motivation significantly improve adherence, with motivation playing a key mediating role.
Area of Science:
- Rehabilitation Medicine
- Behavioral Science
- Psychology
Background:
- Exercise adherence is vital for reducing disability and mortality in stroke survivors.
- Factors influencing low exercise adherence among stroke survivors are not fully understood.
- The Capability, Opportunity, Motivation, and Behavior (COM-B) model provides a framework for exploring these factors.
Purpose of the Study:
- To investigate the factors influencing exercise adherence in stroke survivors.
- To examine the roles of psychological resilience, social support, and rehabilitation motivation in exercise adherence.
- To explore the mediating effect of rehabilitation motivation on the relationship between resilience, social support, and adherence.
Main Methods:
- A cross-sectional study involving 359 stroke survivors recruited from a tertiary hospital.
- Data collected using demographic questionnaires, Connor-Davidson Resilience Scale, Social Support Rating Scale, Stroke Rehabilitation Motivation Scale, and Stroke Functional Exercise Adherence Questionnaire Scale.
- Structural Equation Modeling (SEM) was employed for data analysis.
Main Results:
- Psychological resilience (β=0.174), social support (β=0.184), and rehabilitation motivation (β=0.517) significantly predicted exercise adherence.
- Psychological resilience (β=0.142) and social support (β=0.218) indirectly influenced exercise adherence by enhancing rehabilitation motivation.
- SEM analysis confirmed a satisfactory model fit, indicating the robustness of the findings.
Conclusions:
- Improving exercise adherence in stroke survivors necessitates focusing on psychological resilience, social support, and rehabilitation motivation.
- Rehabilitation motivation acts as a significant mediator, linking psychological resilience and social support to exercise adherence.
- Targeted interventions addressing these psychological and social factors can enhance adherence and optimize stroke recovery.