The process of commitment to exercise among stroke survivors in Canada.

The objective of this research was to understand the process of commitment to exercise participation for functional recovery among community-living survivors of stroke following discharge from formal rehabilitation. Participants were recruited from a mid-sized city in south-western Ontario, Canada. Between September 2017 and March 2018, 10 individuals living in the community with the effects of stroke, who continued to engage in regular exercise post-stroke, were recruited for participation. Constructivist grounded theory methodology was employed, utilising in-depth individual interviews and theoretical sampling, whereby data collection and analysis occurred simultaneously. Analysis involved constant comparison between data and codes to reduce knowledge gaps and formulate the proposed theory. The process of commitment to exercise involved four phases. Initiation of the process followed a significant interaction with a healthcare provider who advocated for participants to learn the foundations of exercise. Through planned exercise, maintenance of a positive attitude and comparisons with their pre-stroke selves and peers, participants identified future goals and imparted the desire to get back to life before stroke. Over time individuals navigated exercise opportunities-trialling different types and environments-to learn what works. Finally, participants developed a commitment to exercise as a way of life, supported by social connections and reinforced with pride in successes-mastering self-care skills, improved mobility and meaningful function. The process of commitment to exercise among survivors of stroke required early interactions with healthcare providers to initiate exercise participation for long-term engagement, and navigation through various exercise elements fuelled by a desire to reconnect with their pre-stroke selves.