Early prediction of physical activity level 1 year after stroke: a longitudinal cohort study

Olsson, Ola; Persson, Hanna; Murphy, Margit Alt; Sunnerhagen, Katharina S.

doi:10.1136/bmjopen-2017-016369

Cited by 21 publications

(18 citation statements)

References 39 publications

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“…There were a few more inactive participants at 6 months after stroke, compared to before stroke, but we found no significant difference between pre- and post-stroke physical activity on a group level. This result is in line with two previous studies 13 , 31 . Regular pre-stroke physical activity has been found to predict a better functional outcome after stroke 32 , 33 .…”

Section: Discussionsupporting

confidence: 94%

“…Despite this, stroke survivors are less active and spend more time sedentary compared to stroke-free people of the same age 10 , 11 . Factors such as age, sex, pre-stroke physical activity, functioning, depression, fatigue, self-efficacy, and quality of life have previously been associated with the level of post-stroke physical activity 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

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Levels of physical activity before and after stroke in relation to early cognitive function

Viktorisson

Andersson

Lundström

et al. 2021

Sci Rep

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Regular physical activity is widely recommended in the primary and secondary prevention of stroke. Physical activity may enhance cognitive performance after stroke, but cognitive impairments could also hinder a person to take part in physical activity. However, a majority of previous studies have not found any association between post-stroke cognitive impairments and a person’s subsequent level of activity. In this explorative, longitudinal study, we describe the intraindividual change in physical activity from before to 6 months after stroke, in relation to early screening of post-stroke cognitive impairments. Participants were recruited at 2 to 15 days after stroke, and screened for cognitive impairments using the Montreal Cognitive Assessment tool. Information on pre-stroke physical activity was retrospectively collected at hospital admittance by physiotherapists. Post-stroke physical activity was evaluated after 6 months. Of 49 participants included, 44 were followed up. The level of physical activity changed in more than half of all participants after stroke. Participants who were physically active 6 months after stroke presented with significantly less cognitive impairments. These results highlight that many stroke survivors experience a change in their physical activity level following stroke, and that unimpaired cognition may be important for a stroke survivors’ ability to be physically active.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Levels of physical activity before and after stroke in relation to early cognitive function

Viktorisson

Andersson

Lundström

et al. 2021

Sci Rep

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“…We found that higher exercise derived VO 2peak levels are correlated with age. These results are consistent with existing evidence in which age is recognized as a well‐established factor predictive of fitness levels in healthy people and after stroke . We also found a strong correlation with a nonexercise estimate of fitness.…”

Section: Discussionsupporting

confidence: 92%

Safety of Performing a Graded Exercise Test Early after Stroke and Transient Ischemic Attack

Johnson

Kramer

Catanzariti

et al. 2019

PM&R

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Background: Low cardiorespiratory fitness (CRF) is a predictor of stroke risk and poor outcome poststroke. Fitness levels are rarely assessed in the acute phase and it is unclear if it is safe for stroke survivors and people with transient ischemic attack (TIA) to perform a graded exercise test to assess fitness. Objective: To determine if people within 14 days post stroke can safely perform a graded exercise test. Design: Observational study. Setting: Research institute. Participants: People with stroke or TIA admitted to an acute stroke unit. Intervention: Not applicable. Main Outcome Measures: Safety of performing a graded exercise test early post stroke. Safety outcomes were (1) occurrence of an adverse event or (2) <85% blood oxygen saturation (SpO 2 ). Participants performed a graded exercise test on a recumbent stepper at a research institute <2 weeks postevent. CRF was determined by measuring peak volume of oxygen uptake (VO 2peak ) using a metabolic cart. Results: Twenty-nine participants were enrolled in the study (median age 69 years; interquartile range 58-75). Sixteen were diagnosed with TIA and 13 with a mild stroke. Twenty-eight participants completed the test; one participant was unable to perform the test due to back pain. The test was terminated due to standardized stopping criteria in 26 cases (5 = volitional fatigue, 6 = unable to keep required cadence, 15 = reaching 85% HR max ), one due to safety (ie, SpO 2 < 85%), and one was inadvertently terminated before stopping criteria were reached. Average CRF determined by the exercise test was low; mean VO 2peak of 16.2 AE 4.5 mL/kg/min for men (n = 20) and 12.4 AE 3.6 mL/kg/min for women (n = 8). Conclusions: Determining exercise capacity early post stroke and TIA using a graded exercise test appears to be safe in patients with mild deficits. This information should be useful to plan tailored exercise programs. Further research should focus on determining safety of exercise testing in more severely affected stroke survivors.

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“…Older age has been associated with low MVPA levels in people with stroke. 39 Earlier research in an elderly population showed that age was a predictor for low MVPA levels but not for the amount of LPA. 40 Therefore, although sedentary prolongers are older, higher levels of LPA seem to be feasible.…”

Section: Discussionmentioning

confidence: 97%

Movement Behavior Patterns in People With First-Ever Stroke

Wondergem

Veenhof

Wouters

et al. 2019

Stroke

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Background and Purpose— Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns. Methods— Cross-sectional design using data from 190 people with first-ever stroke discharged to the home setting. Movement, behavior was measured over 2 weeks using an accelerometer. Ten movement behavior outcomes were calculated and compressed using principal component analysis. Movement behavior patterns were identified using a k-means clustering algorithm. Demographics, stroke, care, physical functioning, and psychological, cognitive and social factors were obtained. Differences between and factors associated with the patterns were investigated. Results— On average, the accelerometer was worn for 13.7 hours per day. The average movement behavior of the participants showed 9.3 sedentary hours, 3.8 hours of light physical activity, and 0.6 hours of moderate-vigorous physical activity. Three patterns and associated factors were identified: (1) sedentary exercisers (22.6%), with a relatively low age, few pack-years, light drinking, and high levels of physical functioning; (2) sedentary movers (45.8%), with less severe stroke symptoms, low physical functioning and high levels of self-efficacy; and (3) sedentary prolongers (31.6%), with more severe stroke symptoms, more pack-years, and low levels of self-efficacy. Conclusions— The majority of people with stroke are inactive and sedentary. Three different movement behavior patterns were identified: sedentary exercisers, sedentary movers, and sedentary prolongers. The identified movement behavior patterns confirm the hypothesis that an individually tailored approach might be warranted with movement behavior coaching by healthcare professionals.

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Early prediction of physical activity level 1 year after stroke: a longitudinal cohort study

Cited by 21 publications

References 39 publications

Levels of physical activity before and after stroke in relation to early cognitive function

Levels of physical activity before and after stroke in relation to early cognitive function

Safety of Performing a Graded Exercise Test Early after Stroke and Transient Ischemic Attack

Movement Behavior Patterns in People With First-Ever Stroke

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