{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:21:31Z","timestamp":1791649291813,"version":"4.3.4"},"reference-count":62,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>After a stroke incident, physical inactivity is common. People with stroke may perceive several barriers to performing physical activity (PA). This study aimed to document the PA level and understand the barriers and facilitators to engaging in PA for community-dwelling stroke survivors in Benin, a lower middle-income country. A cross-sectional study was conducted in three hospitals in Benin. Levels of PA were recorded by means of the Benin version of the International Physical Activity Questionnaire long form (IPAQ-LF-Benin), which is validated for stroke survivors in Benin. The perceived exercise facilitators and barriers were assessed by the Stroke Exercise Preference Inventory-13 (SEPI-13). A descriptive analysis and associations were performed with a Confidence Interval of 95% and &lt;0.05 level of significance. A total of 87 participants (52 men, mean age of 53 \u00b1 10 years, mean time after a stroke of 11 (IQR: 15) months and an average of 264.5 \u00b1 178.9 m as distance on the 6 min walking test (6MWT) were included. Overall, stroke survivors in Benin reached a total PA of 985.5 (IQR: 2520) metabolic equivalent (METs)-minutes per week and were least active at work, domestic, and leisure domains with 0 MET-minutes per week. The overview of PA level showed that 52.9% of participants performed low PA intensity. However, 41.4% performed moderate PA or walking per day for at least five days per week. Important perceived barriers were lack of information (45.3%), hard-to-start exercise (39.5%), and travelling to places to exercise (29.9%). The preference for exercise was with family or friends, outdoors, for relaxation or enjoyment (90.2%), and receiving feedback (78.3%). Several socio-demographic, clinical, and community factors were significantly associated with moderate or intense PA (p &lt; 0.05) in stroke survivors in this study. Our findings show that the PA level among chronic stroke survivors in Benin is overall too low relative to their walking capacity. Cultural factors in terms of the overprotection of the patients by their entourage and\/or the low health literacy of populations to understand the effect of PA on their health may play a role. There is a need for new approaches that consider the individual barriers and facilitators to exercise.<\/jats:p>","DOI":"10.3390\/ijerph20031784","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T02:04:35Z","timestamp":1674093875000},"page":"1784","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Physical Activity Level, Barriers, and Facilitators for Exercise Engagement for Chronic Community-Dwelling Stroke Survivors in Low-Income Settings: A Cross-Sectional Study in Benin"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7628-2644","authenticated-orcid":false,"given":"S\u00e8nad\u00e9 In\u00e8s","family":"Noukpo","sequence":"first","affiliation":[{"name":"Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou 01 BP 02, Benin"},{"name":"REVAL, Rehabilitation Research Center, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Tedesco","family":"Triccas","sequence":"additional","affiliation":[{"name":"REVAL, Rehabilitation Research Center, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7729-4700","authenticated-orcid":false,"given":"Bruno","family":"Bonnech\u00e8re","sequence":"additional","affiliation":[{"name":"REVAL, Rehabilitation Research Center, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Adoukonou","sequence":"additional","affiliation":[{"name":"Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou 01 BP 02, Benin"},{"name":"ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou 03 BP 10, Benin"},{"name":"Department of Neurology, Faculty of Medicine, University of Parakou, Parakou 03 BP 10, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-5495","authenticated-orcid":false,"given":"Peter","family":"Feys","sequence":"additional","affiliation":[{"name":"REVAL, Rehabilitation Research Center, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-7191","authenticated-orcid":false,"given":"Oy\u00e9n\u00e9","family":"Kossi","sequence":"additional","affiliation":[{"name":"Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou 01 BP 02, Benin"},{"name":"REVAL, Rehabilitation Research Center, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou 03 BP 10, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1161\/STR.0b013e318296aeca","article-title":"An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"44","author":"Sacco","year":"2013","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1177\/1747493021990945","article-title":"Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis","volume":"16","author":"Adoukonou","year":"2021","journal-title":"Int. J. Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4236\/nm.2018.92009","article-title":"Short term (3 months) prognosis of stroke in Parakou","volume":"9","author":"Adoukonou","year":"2018","journal-title":"Neurosci. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: Update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1682\/JRRD.2007.02.0042","article-title":"Barriers associated with exercise and community access for individuals with stroke","volume":"45","author":"Rimmer","year":"2008","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.47985\/dcidj.571","article-title":"Content and effectiveness of community-based rehabilitation on quality of life in people post stroke: A systematic review with meta-analysis","volume":"33","author":"Noukpo","year":"2022","journal-title":"Disabil. CBR Incl. Dev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2532","DOI":"10.1161\/STR.0000000000000022","article-title":"Physical activity and exercise recommendations for stroke survivors: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"45","author":"Billinger","year":"2014","journal-title":"Stroke"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.apmr.2013.12.016","article-title":"Interventions to promote long-term participation in physical activity after stroke: A systematic review of the literature","volume":"95","author":"Morris","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3760","DOI":"10.1080\/09638288.2021.1894247","article-title":"Effectiveness of walking training on balance, motor functions, activity, participation and quality of life in people with chronic stroke: A systematic review with meta-analysis and meta-regression of recent randomized controlled trials","volume":"44","author":"Nindorera","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"2011 Compendium of Physical Activities: A second update of codes and MET values","volume":"43","author":"Ainsworth","year":"2011","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_11","first-page":"200","article-title":"Letter to the Editor: Standardised use of the terms \u201csedentary\u201d and \u201csedentary behaviours\"","volume":"18","author":"Tremblay","year":"2012","journal-title":"Afr. J. Phys. Act. Health Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.2337\/dc10-2313","article-title":"Sitting time and waist circumference are associated with glycemia in UK South Asians: Data from 1,228 adults screened for the PODOSA trial","volume":"34","author":"Gill","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1136\/bjsports-2011-085662","article-title":"Television viewing time and reduced life expectancy: A life table analysis","volume":"46","author":"Veerman","year":"2012","journal-title":"Br. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1177\/1545968314562116","article-title":"Effects of community exercise therapy on metabolic, brain, physical, and cognitive function following stroke: A randomized controlled pilot trial","volume":"29","author":"Moore","year":"2015","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3109\/09638280903095916","article-title":"Effectiveness of a community-based low intensity exercise programme for ambulatory stroke survivors","volume":"32","author":"Cramp","year":"2010","journal-title":"Disabil. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/j.1532-5415.2007.01185.x","article-title":"Stroke: A randomized trial of exercise or relaxation","volume":"55","author":"Mead","year":"2007","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1161\/01.STR.0000181076.91805.89","article-title":"Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: A randomized, controlled trial","volume":"36","author":"Macko","year":"2005","journal-title":"Stroke"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1016\/j.apmr.2009.07.015","article-title":"Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: A randomized controlled trial","volume":"90","author":"Mudge","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_19","first-page":"CD003316","article-title":"Physical fitness training for stroke patients","volume":"2020","author":"Saunders","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_20","unstructured":"Scottish Intercollegiate Guidelines Network (2008). Management of Patients with Stroke or TIA: Assessment, Investigation, Immediate Management and Secondary Prevention: A National Clinical Guideline, Scottish Intercollegiate Guidelines Network."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e001430","DOI":"10.1161\/JAHA.114.001430","article-title":"Physical activity and health: What is the best dose?","volume":"3","author":"Kaminsky","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1310\/tsr2103-246","article-title":"Prevalence of physical activity and sedentary behavior among stroke survivors in the United States","volume":"21","author":"Butler","year":"2014","journal-title":"Top. Stroke Rehabil."},{"key":"ref_23","first-page":"113","article-title":"Comparative influence of self-efficacy, social support and perceiived barriers on low physical activity development in patients with type 2 diabetes, hypertension or stroke","volume":"22","author":"Adeniyi","year":"2012","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.7717\/peerj.489","article-title":"Physical activity habits and preferences in the month prior to a first-ever stroke","volume":"2","author":"McDonnell","year":"2014","journal-title":"PeerJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/j.2048-7940.2007.tb00183.x","article-title":"Barriers and facilitators to exercise among stroke survivors","volume":"32","author":"Damush","year":"2007","journal-title":"Rehabil. Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"274","DOI":"10.11604\/pamj.2015.21.274.6669","article-title":"Perceived barriers to physical activity among Nigerian stroke survivors","volume":"21","author":"Idowu","year":"2015","journal-title":"Pan Afr. Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2522\/ptj.20130175","article-title":"Physical activity and sedentary behaviors in people with stroke living in the community: A systematic review","volume":"94","author":"English","year":"2014","journal-title":"Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"Koudstaal","year":"1988","journal-title":"stroke"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/1099-1166(200006)15:6<521::AID-GPS182>3.0.CO;2-F","article-title":"Community screening interview for dementia (CSI \u2018D\u2019); performance in five disparate study sites","volume":"15","author":"Hall","year":"2000","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1123\/jpah.5.2.308","article-title":"Inflated perceptions of physical activity after stroke: Pairing self-report with physiologic measures","volume":"5","author":"Resnick","year":"2008","journal-title":"J. Phys. Act. Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.hkpj.2013.01.041","article-title":"Reliability and validity of the Modified Functional Ambulation Classification in patients with hip fracture","volume":"31","author":"Chau","year":"2013","journal-title":"Hong Kong Physiother. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0002-8703(03)00119-4","article-title":"The 6-minute walk test: How important is the learning effect?","volume":"146","author":"Wu","year":"2003","journal-title":"Am. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/occmed\/kqx063","article-title":"The Borg rating of perceived exertion (RPE) scale","volume":"67","author":"Williams","year":"2017","journal-title":"Occup. Med."},{"key":"ref_34","first-page":"109","article-title":"The Timed Get-up-and-Go test revisited: Measurement of the component tasks","volume":"37","author":"Wall","year":"2000","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_35","unstructured":"Honado, S.A. (2019). Adaptation et Validation du Questionnaire International de L\u2019activit\u00e9 Physique (IPAQ) Chez Les Personnes Saines et Les Survivants D\u2019un Accident Vasculaire C\u00e9r\u00e9bral au B\u00e9nin, Universit\u00e9 Laval."},{"key":"ref_36","unstructured":"IPAQ Research Committee (2005). International Physical Activity Questionnaire (IPAQ), IPAQ Research Committee."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Bonner, N.S., O\u2019Halloran, P.D., Bernhardt, J., and Cumming, T.B. (2016). Developing the stroke exercise preference inventory (SEPI). PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0164120"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Houehanou, Y.C.N., Agbetou, M., Kossi, O., Agonnoud\u00e9, M., Hountada, H., and Adoukonou, T. (2022). Prevalence and factors associated with stroke risk factors in an urban community of Parakou, Northern Benin, 2016. PLoS Glob. Public Health, 2.","DOI":"10.1371\/journal.pgph.0000667"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3729","DOI":"10.1007\/s10072-021-05578-4","article-title":"Stroke survivors with the same levels of exercise as healthy individuals have lower levels of physical activity","volume":"43","author":"Ferreira","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ruescas-Nicolau, M.-A., S\u00e1nchez-S\u00e1nchez, M.L., Cort\u00e9s-Amador, S., P\u00e9rez-Alenda, S., Arnal-G\u00f3mez, A., Climent-Toledo, A., and Carrasco, J.J. (2021). Validity of the international physical activity questionnaire long form for assessing physical activity and sedentary behavior in subjects with chronic stroke. Int. J. Environ. Res. Public. Health, 18.","DOI":"10.3390\/ijerph18094729"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.healthplace.2014.06.001","article-title":"Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa","volume":"29","author":"Adjiwanou","year":"2014","journal-title":"Health Place"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Owoo, N.S., and Lambon-Quayefio, M.P. (2021). Mixed methods exploration of Ghanaian women\u2019s domestic work, childcare and effects on their mental health. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245059"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1001\/jama.2013.3519","article-title":"Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study","volume":"309","author":"Teo","year":"2013","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"101265","DOI":"10.1016\/j.dhjo.2021.101265","article-title":"A description of physical activity behaviors, barriers, and motivators in stroke survivors in Quebec","volume":"15","author":"Gagnon","year":"2022","journal-title":"Disabil. Health J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/JSA.0000000000000242","article-title":"Impact of adaptive sports participation on quality of life","volume":"27","author":"Diaz","year":"2019","journal-title":"Sports Med. Arthrosc. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1111\/sms.12218","article-title":"Barriers to and facilitators of sports participation for people with physical disabilities: A systematic review","volume":"24","author":"Jaarsma","year":"2014","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"128","DOI":"10.5853\/jos.2013.15.3.128","article-title":"Stroke epidemiology and stroke care services in India","volume":"15","author":"Pandian","year":"2013","journal-title":"J. Stroke"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/09638288.2019.1624396","article-title":"Perceived barriers to exercise reported by individuals with stroke, who are able to walk in the community","volume":"43","author":"Scianni","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1747-4949.2012.00880.x","article-title":"A systematic review of perceived barriers and motivators to physical activity after stroke","volume":"8","author":"Nicholson","year":"2013","journal-title":"Int. J. Stroke"},{"key":"ref_50","unstructured":"Jackson, S.M. (2015). An Investigation of Factors Influencing Physical Activity Levels in People Living in the Community after Stroke, University of Western Australia."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"520","DOI":"10.12968\/ijtr.2011.18.9.520","article-title":"Exercise perceptions among people with stroke: Barriers and facilitators to participation","volume":"18","author":"Simpson","year":"2011","journal-title":"Int. J. Ther. Rehabil."},{"key":"ref_52","first-page":"407","article-title":"Perceptions of hypertension and contributing personal and environmental factors among rural Southern African American women","volume":"19","author":"Ford","year":"2009","journal-title":"Ethn. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1080\/01612840500502742","article-title":"The burden of hypertension: Mental representations of African American women","volume":"27","author":"Webb","year":"2006","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.maturitas.2021.11.009","article-title":"Patterns of physical activity and sedentary behavior and their associated factors among nondisabled stroke survivors","volume":"158","author":"Choi","year":"2022","journal-title":"Maturitas"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1161\/01.CIR.0000126280.65777.A4","article-title":"Physical activity and exercise recommendations for stroke survivors: An American Heart Association scientific statement from the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council","volume":"109","author":"Gordon","year":"2004","journal-title":"Circulation"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1136\/bjsports-2017-098903","article-title":"Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack: A systematic review and meta-analysis","volume":"53","author":"Wang","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1249\/01.mss.0000181303.51937.9c","article-title":"Profile of physical activity levels in community-dwelling older adults","volume":"37","author":"Chad","year":"2005","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1177\/019394502237699","article-title":"Perceived benefits and barriers to physical activity among older Latina women","volume":"24","author":"Juarbe","year":"2002","journal-title":"West. J. Nurs. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/216507999003801203","article-title":"Interviewer bias: How it affects survey research","volume":"38","author":"Salazar","year":"1990","journal-title":"Aaohn J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.06.007","article-title":"A home-and community-based physical activity program can improve the cardiorespiratory fitness and walking capacity of stroke survivors","volume":"25","author":"Marsden","year":"2016","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e25906","DOI":"10.2196\/25906","article-title":"The Effectiveness of Physical Activity-Promoting Web-and Mobile-Based Distance Weight Loss Interventions on Body Composition in Rehabilitation Settings: Systematic Review, Meta-analysis, and Meta-Regression Analysis","volume":"24","author":"Lahtio","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1016\/S0140-6736(17)31634-3","article-title":"The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: The PURE study","volume":"390","author":"Lear","year":"2017","journal-title":"Lancet"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/1784\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:09:35Z","timestamp":1760119775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/1784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":62,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20031784"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20031784","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]}}}