Family’s presence associated with increased physical activity in patients with acute stroke: an observational study

Abstract

Background:Inherent differences in organization of stroke care and rehabilitation practices in various settings influence the activity levels of patients in the hospital. The majority of published studies have been carried out in developed countries such as the United States, United Kingdom, Australia, Switzerland and Belgium; however, data from developing countries are scarce.Objective:To measure the amount and nature of physical activity of patients admitted to medical wards of Indian hospitals and to assess the association between family presence and the patient and between the patient’s functional status and their physical activity level.Method:This is an observational behavioral mapping study. A trained physical therapist recorded the patients’ (N=47) physical activity level through direct observation in the ward using a predetermined observation scheme.Results:Participants were found inactive and alone for 19% (inter quartile range [IQR] 12-36%) and 15% (IQR 10-19%) of the time during the day, respectively. They spent 46% (IQR 31-55%) of the time in therapeutic activities and 31% (IQR 22-34%) of the time in non-therapeutic activities. The family was present with patients 50% of the time during the day. Family presence with the patient and the patient’s moderate dependence in daily activities are positively associated with their activity levels.Conclusion:Patients with stroke admitted to Indian hospitals spent less time being inactive and alone and more time with family participating in therapeutic activities. The presence of family members with the patients during hospital stay may be a significant resource for encouraging patients to be more active.

Motivational Strategies for Stroke Rehabilitation: A Descriptive Cross-Sectional Study

“…In addition, Dobkin et al (9) found that praise and positive feedback were effective for improving walking speed in patients with stroke. Thus, the present results are partly consistent with the previous qualitative (2,3,17,18) and experimental reports (9,12,13,34,36) from Western countries. The advantage of this study was that it represents the first extensive survey to quantitatively investigate the actual motivational strategies used in stroke rehabilitation.…”

“…Sonoda et al (33) found that providing a specific rehabilitation environment for stroke inpatients increased the amount of physical activity that they engaged in during activities of daily living. Furthermore, providing information about rehabilitation and insuring that a family member is present during rehabilitation may be effective in improving a patient's mood and encouraging them to become more active (12,34).…”

Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: a mixed methods study

“…The family presence with the patient and the patient’s moderate dependence in daily activities were positively associated with their activity levels. The authors concluded that the presence of family members with the patients during hospital stay may be a significant resource for encouraging patients to be more active [ 57 ]. Two smaller studies showed that patients in Dutch nursing homes were inactive and alone for up to 49% and 60% of the day [ 58 , 59 ].…”

Acute Hospital Admission for Stroke Is Characterised by Inactivity

“…In the majority of studies, physical activity is measured within the first weeks after stroke using observational behavioural mapping [8]. For example, Prakash et al investigated the amount and patterns of physical activity of stroke survivors (n = 47) admitted to a medical ward in India [9], and Astrand et al investigated physical activity of stroke survivors (n = 86) admitted to an acute stroke ward in Sweden [10]. In both studies, intermittent observational mapping was used where participants were observed at 10-minute intervals during the most active part of the day only (e.g., 8 : 30 am to 6 : 00 pm) [9,10].…”