Inactive lifestyles and sedentary behavior in persons with chronic aneurysmal subarachnoid hemorrhage: evidence from accelerometer-based activity monitoring

Abstract

BackgroundAneurysmal subarachnoid hemorrhage (a-SAH) is a potential life-threatening stroke. Because survivors may be at increased risk for inactive and sedentary lifestyles, this study evaluates physical activity (PA) and sedentary behavior (SB) in the chronic phase after a-SAH.MethodsPA and SB were objectively measured at six months post a-SAH with an accelerometer-based activity monitor, with the aim to cover three consecutive weekdays. Total time spent in PA (comprising walking, cycling, running and non-cyclic movement) and SB (comprising sitting and lying) was determined. Also, in-depth analyses were performed to determine the accumulation and distribution of PA and SB throughout the day. Binary time series were created to determine the mean bout length and the fragmentation index. Measures of PA and SB in persons with a-SAH were compared to those in sex- and age-matched healthy controls.ResultsThe 51 participants comprised 33 persons with a-SAH and 18 controls. None of the participants had signs of paresis or spasticity. Persons with a-SAH spent 105 min/24 h being physically active, which was 35 min/24 h less than healthy controls (p = 0.005). For PA, compared with healthy controls, the mean bout length was shorter in those with a-SAH (12.0 vs. 13.5 s, p = 0.006) and the fragmentation index was higher (0.053 vs. 0.041, p < 0.001). Total sedentary time during waking hours showed no significant difference between groups (514 min vs. 474 min, p = 0.291). For SB, the mean bout length was longer in persons with a-SAH (122.3 vs. 80.5 s, p = 0.024), whereas there was no difference in fragmentation index between groups (0.0032 vs 0.0036, p = 0.396).ConclusionsPersons with a-SAH are less physically active, they break PA time into shorter periods, and SB periods last longer compared to healthy controls. Since inactive lifestyles and prolonged uninterrupted periods of SB are independent risk factors for poor cardiovascular health, interventions seem necessary and should target both PA and SB.Study registrationDutch registry number: NTR 2085.

Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study

“…Consequently, PA in daily life might be more effortful for people with SAH than for healthy people, resulting in higher fatigue directly after being more physically active [ 35 ]. Exercise training to improve physical fitness, might reduce fatigue or prevent high post-activity fatigue, especially since people with SAH are found to be less physically active than healthy controls and often seems not to adhere to the PA and exercise recommendations for stroke survivors [ 9 , 36 ]. Also, this may aid in breaking the vicious circle of deconditioning, that proposes that fatigue results in physical inactivity, leading to lower physical fitness and even more fatigue [ 33 , 35 ].…”

“…To date, there is no effective rehabilitation program specifically aimed at fatigue in patients with SAH or stroke [ 8 ]. Recent studies have shown that people with aneurysmal subarachnoid hemorrhage (A-SAH) have lower levels of physical activity (PA) than healthy controls [ 9 ] and that PA is indirectly associated with fatigue in this group. Those who are less physically active, have worse physical fitness, [ 10 ] which is associated with higher levels of fatigue [ 11 ].…”

Effect of different operationalizations of sedentary behavior in people with chronic stroke

“…The VitaMove consists of three body-fixed accelerometers (Freescale MMA7260Q, Denver, USA), one attached to the sternum and one to each thigh. The three sensors are wirelessly connected and synchronize every 10 s; full details on this device are published elsewhere [31,32].…”

The effect of induced hypertension in aneurysmal subarachnoid hemorrhage: A narrative review

“… 18 , 19 This devastating disease accounts for up to 2%-5% of all stroke cases with a considerable mortality rate of 40%-60%. 1 - 4 , 20 , 21 Recent investigations have indicated decreasing mortality rate, which may be due to technical advances in medicine, along with a better knowledge of the disease, its treatment, and complications. 22 , 23 Its incidence varies markedly by geographic region, age, and gender, but the overall incidence of aSAH is 7.9 per 100000 person-years.…”