Efficacy of interventions aimed at improving physical activity in individuals with stroke: a systematic review

Aguiar, Larissa Tavares; Nadeau, Sylvie; Martins, Júlia Caetano; Teixeira-Salmela, Luci Fuscaldi; Britto, Raquel Rodrigues; Faria, Christina Danielli Coelho de Morais

doi:10.1080/09638288.2018.1511755

Cited by 28 publications

(27 citation statements)

References 45 publications

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“…Prior reviews of physical activity poststroke described physical activity levels, approaches to measuring physical activity, and nonpharmacological interventions promoting adherence to physical activity recommendations or exercise programs . A recent systematic review examined randomized controlled trials that included measures of physical activity . However, the influence of nonpharmacological interventions on sedentary behavior and frequent engagement in daily activity remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Influence of Interventions on Daily Physical Activity and Sedentary Behavior after Stroke: A Systematic Review

Kringle

Gibbs

Campbell

et al. 2019

PM&R

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Background Evidence suggests that frequent engagement in daily activities requiring physical activity may influence risk factors for recurrent stroke. The effects of nonpharmacological interventions on daily physical activity levels and sedentary behavior are unclear. Objective To describe the effects of interventions on levels of daily physical activity and sedentary behavior among people with stroke. Methods OVID/Medline, CINAHL, PsycINFO, and the Cochrane Database were searched using the following search terms: stroke, rehabilitation, intervention, sedentary, physical activity, lifestyle, self‐management, and exercise. Data extraction and risk of bias assessment were conducted by two authors. Results Thirty‐one interventions were identified that included exercise, behavior change techniques, and education components. These components were delivered alone and in varying combinations. At postintervention, between‐group effects on change scores (Cohen's d = 0.17–0.75, P < .05) or between‐group differences in odds of participating in daily physical activity (odds ratio [OR] = 2.07, P < .05) were detected in six studies, and within‐group effects in nine studies (Cohen's d = 0.21–3.97, P < .05). At follow‐up, between‐group differences in odds of participating in daily physical activity were detected in one study (OR = 2.64, P < .05), and within‐group effects in two studies (Cohen's d = 0.25, P < .05). No effects (P < .05) were detected in 17 studies. Conclusion It may be possible to modify daily physical activity levels and sedentary behavior poststroke; however, there is insufficient evidence to suggest the superiority of a particular intervention approach. Future studies should explore the unique contributions of individual intervention components to guide development of parsimonious multicomponent interventions that are effective for promoting daily physical activity and reducing sedentary behavior among people with stroke. Level of Evidence I.

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Section: Introductionmentioning

confidence: 99%

Influence of Interventions on Daily Physical Activity and Sedentary Behavior after Stroke: A Systematic Review

Kringle

Gibbs

Campbell

et al. 2019

PM&R

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“…Because a sedentary lifestyle is prevalent after stroke and constitutes an important vascular risk factor, counseling to increase daily physical activity is generally recommended for all stroke patients [ 34 ]. However, advocating a more elaborate program, such as a behavioral lifestyle interventions [ 35 ] to increase physical activity, may not be appropriate in patients who are active and meet the current recommendations, such as patients #1, 4, 12, and 14 (who spent 17–20% of their time walking). Information that a patient is mostly sedentary and spends little time walking may prompt the rehabilitation physician to enquire about the reasons, which may include low cardiorespiratory fitness, fear of falls, fatigue or depression [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…These examples show that knowing a patient’s physical activity profile could aid the rehabilitation physician in choosing appropriate rehabilitative therapies. Additionally, not prescribing an unnecessary therapy, such as a behavioral lifestyle intervention [ 35 ], to increase physical activity in a patient who already meets the recommendations may be more economical than prescribing the same intervention to all patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of assessing motor performance in postacute stroke patients

Flury

Massé

Paraschiv-Ionescu

et al. 2021

J NeuroEngineering Rehabil

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Background Rehabilitative treatment plans after stroke are based on clinical examinations of functional capacity and patient-reported outcomes. Objective information about daily life performance is usually not available, but it may improve therapy personalization. Objective To show that sensor-derived information about daily life performance is clinically valuable for counseling and the planning of rehabilitation programs for individual stroke patients who live at home. Performance information is clinically valuable if it can be used as a decision aid for the therapeutic management or counseling of individual patients. Methods This was an observational, cross-sectional case series including 15 ambulatory stroke patients. Motor performance in daily life was assessed with body-worn inertial sensors attached to the wrists, shanks and trunk that estimated basic physical activity and various measures of walking and arm activity in daily life. Stroke severity, motor function and activity, and degree of independence were quantified clinically by standard assessments and patient-reported outcomes. Motor performance was recorded for an average of 5.03 ± 1.1 h on the same day as the clinical assessment. The clinical value of performance information is explored in a narrative style by considering individual patient performance and capacity information. Results The patients were aged 59.9 ± 9.8 years (mean ± SD), were 6.5 ± 7.2 years post stroke, and had a National Institutes of Health Stroke Score of 4.0 ± 2.6. Capacity and performance measures showed high variability. There were substantial discrepancies between performance and capacity measures in some patients. Conclusions This case series shows that information about motor performance in daily life can be valuable for tailoring rehabilitative therapy plans and counseling according to the needs of individual stroke patients. Although the short recording time (average of 5.03 h) limited the scope of the conclusions, this study highlights the usefulness of objective measures of daily life performance for the planning of rehabilitative therapies. Further research is required to investigate whether information about performance in daily life leads to improved rehabilitative therapy results.

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“…15 Treatment effects cannot be detected if a self-report tool shows poor responsiveness. 7,9 A systematic review 42 which investigated the efficacy of interventions to increase physical activity levels after stroke reported the lack of self-report tools that had their responsiveness investigated for subjects with stroke.…”

Section: Discussionmentioning

confidence: 99%

Measurement properties of self-report physical activity assessment tools for patients with stroke: a systematic review

Martins

Aguiar

Nadeau

et al. 2019

Brazilian Journal of Physical Therapy

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Background: Individuals with stroke demonstrate low levels of physical activity. Self-report measures of physical activity are frequently used and the choice of the best one to use for each purpose and context should take into account the measurement properties of these instruments. Objective: To summarize the measurement properties and clinical utility of self-report measures of physical activity of post-stroke subjects and to evaluate both the methodological quality of the studies and the quality of the measurement properties. Methods: Searches were made in MEDLINE, EMBASE, PEDro, LILACS, and SCIELO. Two reviewers independently screened studies that investigated measurement properties or clinical utility of self-report measures of physical activity in post-stroke subjects. The studies' methodological quality, quality of the measurement properties, and clinical utility were evaluated. Results: From the 11,826 identified studies, 19 were included. Six self-report tools were evaluated: The Activity card sort, Coded activity diary, Frenchay activities index (FAI), Human activity profile (HAP), Multimedia activity recall for children and adults, and the Nottingham leisure questionnaire. The methodological quality of the studies ranged from ''poor'' to ''good''. Most of the results regarding the quality of the measurement properties were doubtful. None of the self-report tools had their content validity investigated. The FAI and HAP showed the highest clinical utility scores.

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Efficacy of interventions aimed at improving physical activity in individuals with stroke: a systematic review

Cited by 28 publications

References 45 publications

Influence of Interventions on Daily Physical Activity and Sedentary Behavior after Stroke: A Systematic Review

Influence of Interventions on Daily Physical Activity and Sedentary Behavior after Stroke: A Systematic Review

Clinical value of assessing motor performance in postacute stroke patients

Measurement properties of self-report physical activity assessment tools for patients with stroke: a systematic review

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