{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:10:24Z","timestamp":1790752224043,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC)"},{"name":"an NIHR Senior Investigator Award, awarded to Professor Dame Caroline Watkins"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objectives: To identify barriers and facilitators to engagement when returning to, or participating in, leisure activity post-stroke or Transient Ischemic Attack (TIA). Design: Sequential explanatory, mixed methods study. Setting: 21 hospital sites across England, Wales and Northern Ireland. Participants: Adults with a clinical diagnosis of first\/recurrent stroke or TIA. Patients approaching end of life were excluded. Participants were recruited as in-patients or at first clinic appointment and a baseline questionnaire was completed. A 6-month follow-up questionnaire was sent to participants for self-completion. Open-text questions were asked about barriers and facilitators when returning to, or participating in, leisure activity. Responses were thematically analysed and explored by participant characteristics, including type of leisure activity undertaken. Characteristics also included measures of socioeconomic deprivation, mood, fatigue and disability. Results: 2000 participants returned a 6-month follow-up questionnaire (78% stroke, 22% TIA); 1045 participants responded to a question on barriers and 820 on facilitators. Twelve themes were identified and the proportion of responses were reported (%). Barriers: physical difficulties (69%), lower energy levels (17%), loss of independence (11%), psychological difficulties (10%), hidden disabilities (7%), and delay or lack of healthcare provision (3%). Facilitators: family support (35%), healthcare support (27%), well-being and fitness (22%), friendship support (20%), self-management (19%), and returning to normality (9%). \u2018Physical difficulties\u2019 was the most reported barrier across all participant characteristics and activity types. Family support was the most reported facilitator except for those with greater disability, where it was healthcare support and those without fatigue where it was well-being and exercise. Conclusions: Physical difficulties and lack of energy are problematic for stroke and TIA survivors who want to return to or participate in leisure activity. Healthcare support alone cannot overcome all practical and emotional issues related to leisure activity engagement. Family support and improving well-being are important facilitators and future research should explore these mechanisms further.<\/jats:p>","DOI":"10.3390\/ijerph192114587","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T03:14:26Z","timestamp":1667790866000},"page":"14587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-7240","authenticated-orcid":false,"given":"Joanna","family":"Harrison","sequence":"first","affiliation":[{"name":"Synthesis, Economic Evaluation and Decision Science (SEEDS), Applied Health Research hub (AHRh), University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Thetford","sequence":"additional","affiliation":[{"name":"Stroke Research Team, Faculty of Health and Care, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-2910","authenticated-orcid":false,"given":"Matthew J.","family":"Reeves","sequence":"additional","affiliation":[{"name":"UCLan Research Centre for Sport, Physical Activity & Performance, Faculty of Allied Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Brown","sequence":"additional","affiliation":[{"name":"Lancashire Clinical Trials Unit, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7263-7252","authenticated-orcid":false,"given":"Miland","family":"Joshi","sequence":"additional","affiliation":[{"name":"Lancashire Clinical Trials Unit, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-3772","authenticated-orcid":false,"given":"Caroline","family":"Watkins","sequence":"additional","affiliation":[{"name":"Stroke Research Team, Faculty of Health and Care, University of Central Lancashire, Preston PR1 2HE, UK"},{"name":"Lancashire Clinical Trials Unit, University of Central Lancashire, Preston PR1 2HE, UK"},{"name":"Lancashire Institute for Global Health and Well-being, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1055\/s-0038-1649503","article-title":"Global Burden of Stroke","volume":"38","author":"Katan","year":"2018","journal-title":"Semin. 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