Motivation, Physical Activity, and Affect in Community-Dwelling Stroke Survivors: An Ambulatory Assessment Approach

Background: Motivation is a frequently reported but far less studied driver for post-stroke physical activity participation. Motivation and physical activity may be important contributors to the prevention management and alleviation of affective symptoms among stroke survivors. Purpose: To investigate the real-time associations between motivation, physical activity, and affect in the daily lives of community-dwelling stroke survivors using ecological momentary assessment (EMA) and accelerometry. Methods: Forty community-dwelling stroke survivors wore an accelerometer on the thigh and completed EMA surveys assessing motivation (autonomous motivation, controlled motivation) and affect (negative affect, positive affect) eight times daily for 7 days. Multivariate regression analysis and multilevel modeling investigated the associations between motivation, physical activity, and affect. Results: Greater autonomous motivation for physical activity was associated with less sedentary behavior (β = -0.40, p =. 049) and more moderate-to-vigorous physical activity (β = 0.45, p =. 020) participation in daily life. Greater autonomous motivation was momentarily associated with less depressed affect (β = -0.05, p <. 001) and greater positive affect (β = 0.13, p <. 001). Moreover, greater controlled motivation was momentarily associated with greater depressed affect (β = 0.06, p <. 001). More intense physical activity was momentarily associated with greater positive affect (β = 0.13, p =. 016). No moderating effect of motivation on the association between physical activity and affect was found. Conclusions: Motivation and physical activity are momentarily associated with affect among stroke survivors. Assessing and fostering autonomous motivation may be beneficial for promoting physical activity and managing positive and depressed affect as stroke survivors return to the community.