Barriers and Facilitators to Physical Exercise Participation Among Community-Dwelling Older Adults: A Narrative Review Based on the Socio-Ecological Model

Abstract

Background: Population aging in China's mainland has intensified the need to promote healthy aging. Regular physical activity is widely recognized as an effective strategy to prevent chronic diseases and functional decline among older adults; however, participation levels remain insufficient. Objective: This study aims to synthesize recent evidence on barriers and facilitators to physical exercise participation among community-dwelling older adults in China's mainland using a socio-ecological framework. Methods: A narrative review was conducted based on a structured literature search across PubMed, Web of Science, Scopus, SPORTDiscus, CNKI, and Wanfang databases covering the period from 2010 to March 2025. A total of 76 records were initially identified, of which 32 studies met the inclusion criteria after screening. Thematic synthesis was applied to categorize findings into intrapersonal, interpersonal, and environmental levels. Results: Among the included studies, intrapersonal factors such as fear of falling (reported in 21 studies), chronic conditions (18 studies), and low motivation (15 studies) were the most frequently identified barriers. Key facilitators included perceived health benefits and self-efficacy (20 studies). Interpersonal influences, particularly family caregiving responsibilities and social support, showed both inhibiting and promoting effects. Environmental factors, including accessibility of facilities and urban–rural disparities, were consistently associated with participation levels. Conclusion: Physical activity participation among older adults in China is shaped by multi-level determinants. Interventions should integrate individual, social, and environmental strategies to effectively enhance participation and support national healthy aging goals.