OBJECTIVE: To investigate effects of interventions to promote long-term participation in physical activity (PA) on measures of frequency, duration or intensity of PA at three months or longer in community dwelling stroke survivors. DATA SOURCES: Medline, CINAHL and PsycINFO between 1987 and December 2012. Search terms included "physical activity, exercise promotion"; "stroke"; "behaviour change interventions" and synonyms. STUDY SELECTION: Randomised controlled trials or comparison studies involving stroke survivors, with follow-up of > 3 months, examining interventions to increase long-term participation in PA. DATA EXTRACTION: PRISMA guidelines informed data extraction. Risk of bias was assessed using the Cochrane Collaboration tool. Two reviewers independently reviewed abstracts and extracted data. DATA SYNTHESIS: Of 2,888 studies, 11 involving 1,704 participants were included. Risk of bias occurred in randomisation methods and blinding. Limited data and study heterogeneity meant data pooling was not possible. Odds ratios and continuous data as weighted mean differences were however calculated using fixed-effect models and 95% confidence intervals. Two intervention types were identified: individualised tailored counselling with or without supervised exercise (n = 6 studies) and supervised exercise with advice (n = 5). Three studies illustrated increased odds of meeting recommended PA levels and participation in PA at 12 months following tailored counselling (p < 0.05). Two studies showed improved step count at three months with supervised exercise only (p < 0.05), however PA levels had declined by three months. Tailored home exercise was the only predominantly exercise based intervention to demonstrate higher PA participation at 12 months. CONCLUSIONS: This study provides some evidence that tailored counselling alone or with tailored supervised exercise improves long-term PA participation and functional exercise capacity after stroke better than tailored supervised exercise with general advice only. Interventions to improve participation in physical activity should incorporate PA specific tailored counselling based on sound behavioural theory to promote long-term participation in PA.

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