The Relationship Between Environmental Exposures and Post-Stroke Physical Activity

Twardzik, Erica; Clarke, Philippa; Lisabeth, Lynda; Brown, Susan H.; Hooker, Steven P.; Judd, Suzanne E.; Colabianchi, Natalie

doi:10.1016/j.amepre.2022.01.026

Cited by 6 publications

(12 citation statements)

References 51 publications

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“…These restrictions meant the study populations may not be generalizable to the overall stroke population. 12,13 Both may have selection bias due to the inclusion of prevalent stroke survivors and differential participation potentially related to health/disability. In this study, we observed no to minimal effects among those with mild stroke, consistent with these 2 previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Few studies have considered the influence of recreation centers on stroke outcomes. [11][12][13][14][15] Two review articles of primarily qualitative studies reported shorter distances to destinations and places to exercise and walk were beneficial for recovery. 14,15 An exploratory study reported that the number of and distance to recreational facilities were among the top self-reported barriers to exercise among stroke survivors.…”

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confidence: 99%

“…11 Three studies investigated the effect of recreation centers on poststroke physical activity among stroke survivors capable of walking. [11][12][13] Since the study populations were restricted to those capable of walking their findings may not reflect the broader population of stroke survivors, particularly those with more severe stroke. 12,13 To overcome these limitations and build on existing research, we studied the associations between the availability of recreation centers and stroke outcomes in a population-based stroke cohort.…”

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confidence: 99%

“…11 Three studies investigated the effect of recreation centers on poststroke physical activity among stroke survivors capable of walking. 11–13 Since the study populations were restricted to those capable of walking their findings may not reflect the broader population of stroke survivors, particularly those with more severe stroke. 12,13…”

mentioning

confidence: 99%

“…[11][12][13] Since the study populations were restricted to those capable of walking their findings may not reflect the broader population of stroke survivors, particularly those with more severe stroke. 12,13 To overcome these limitations and build on existing research, we studied the associations between the availability of recreation centers and stroke outcomes in a population-based stroke cohort. We hypothesized greater availability of recreation centers would be associated with more favorable poststroke outcomes.…”

mentioning

confidence: 99%

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Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort

Delhey,

Shi,

Morgenstern

et al. 2023

Stroke

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Background: Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes. Methods: We conducted analyses of data from the Brain Attack Surveillance in Corpus Christi project, a cohort of stroke survivors ≥45 years of age residing in Nueces County, TX (2009–2020). We included non-Hispanic White and Mexican American incident stroke survivors, who were not institutionalized prestroke and completed baseline and follow-up assessments (N=1392). We calculated the density of fitness and recreational sports centers within their residential census tract during the year of their stroke. Outcomes included function (self-ratings on activities of daily living and instrumental activities of daily living), cognition (modified mini-mental state exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life Scale). We fit confounder-adjusted gamma-distributed mixed generalized linear models with a log link for each outcome and considered interaction with stroke severity. Results: On average, participants were 65 years old, 53% male, and 63% Mexican American. Median recreational centers were 1.60 per square mile (interquartile range, 0.41–3.06). Among moderate-severe stroke survivors, greater density of recreation centers (75th versus 25th percentile) was associated with more favorable function and possibly quality of life (activities of daily living/instrumental activities of daily living, 4.8% change [95% CI, −0.11% to −9.27%]; Stroke-Specific Quality of Life Scale, 3.7% change [95% CI, −0.7% to 8.2%]). Minimal nonsignificant differences were observed among the overall stroke population and those with mild stroke. Conclusions: The availability of recreation centers may be beneficial for poststroke function and quality of life among those with moderate-severe stroke. If further research confirms recreation centers to be beneficial, this could inform rehabilitation following stroke.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort

Delhey,

Shi,

Morgenstern

et al. 2023

Stroke

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Self‐reported physical activity more than 1 year after stroke and its determinants in relation to the WHO recommendations

Kähler,

Nilsson,

Rosengren

et al. 2025

PM&R

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BackgroundPhysical activity (PA) after stroke has significant health benefits if it is conducted regularly, with sufficient intensity and duration. Because of the health benefits, it is important to identify those below the World Health Organization (WHO) recommended level of PA. However, few studies have assessed the level of PA after stroke in relation to the WHO recommendations and which sociodemographic factors and stroke characteristics are associated with those below the WHO recommendations.ObjectiveTo assess survivors of stroke at least 1 year after onset and (1) describe their self‐reported level of PA; (2) explore the association between PA, sociodemographics, and stroke characteristics, and (3) determine the characteristics of those below the WHO recommended level of PA.DesignCross‐sectional descriptive survey.SettingCommunity settings.ParticipantsData were collected from 160 survivors of stroke (mean age 73 years, 46% women, mean time since stroke onset 35 months).InterventionsNot applicable.Main Outcome MeasuresThe Swedish National Board of Health and Welfare Physical Activity Questionnaire and the following sociodemographics and stroke characteristics: gender, age, marital status, vocational situation, need for home help, use of mobility devices, time since stroke onset, first‐time stroke, type of stroke, location of stroke, and stroke treatment.ResultsTwo thirds (66.3%) of the participants were below the WHO recommendations. The hierarchical regression analysis explained 13% of the variance in PA with need for home help as a single significant contributor. Those who did not meet the WHO recommendations were significantly older, more likely to live alone, and in need of home help and mobility devices.ConclusionsA majority of survivors of stroke do not meet the WHO recommended level of PA. Future studies should assess how other factors characterize those who are physically inactive. This knowledge could help rehabilitation professionals to target interventions and self‐management programs to promote PA among survivors of stroke.

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Green space and stroke: A scoping review of the evidence

Whyte,

Douwes,

Ranta

2024

Journal of the Neurological Sciences

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The Relationship Between Environmental Exposures and Post-Stroke Physical Activity

Cited by 6 publications

References 51 publications

Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort

Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort

Self‐reported physical activity more than 1 year after stroke and its determinants in relation to the WHO recommendations

Green space and stroke: A scoping review of the evidence

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