| Sumario: | Background: Water-based therapeutic exercise (WBTE) is an effective approach for stroke survivors to regain strength, mobility, and quality of life. However, existing trials have not included stroke survivors' perspectives in intervention development, which are critical to ensure a WBTE program meets the needs of stroke survivors and provides supports to enable engagement in ongoing exercise. Methods: Qualitative semi-structured interviews were completed with stroke survivors and caregivers with the aim to have them (1) provide feedback on elements of the intervention resulting from a preceding scoping review and (2) identify barriers, facilitators and other considerations that may impact implementation. Literature on the development of complex health interventions and implementation science informed interview topics. Interviews were analyzed using generic coding and thematic analysis for open-ended and closed-ended questions, respectively. Results: Stroke survivor and caregivers largely confirmed findings from the scoping review regarding intervention characteristics. Four main considerations for implementation were identified in interview analysis: (1) safety, (2) knowledge and beliefs, (3) environment, and (4) individual characteristics. Conclusion: It is essential to consider stroke survivor and caregiver perspectives when developing interventions to promote ongoing exercise following formal rehabilitation. The unique needs of each stroke survivor should be evaluated to optimize participation in WBTE. IMPLICATIONS FOR REHABILITATION: A water-based therapeutic exercise program with sessions 2×/week for 60 min for at least 6–8 weeks was desired and endorsed as feasible for stroke survivors to participate. Stroke survivors and caregivers expressed safety concerns when considering participating in general and water-based exercise, despite having awareness of the benefits. Rehabilitation and recreation professionals should work collaboratively to provide adequate supports and education surrounding the importance of ongoing exercise in this population. Water-based therapeutic exercise programs should consider the unique barriers and facilitators of individual stroke survivors and be flexible to enhance access and participation.
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