Intensity of daily physical activity – a key component for improving physical capacity after minor stroke?

Braakhuis, Hanneke E M; Roelofs, Jolanda M. B.; Berger, Monique; Ribbers, Gerard M.; Weerdesteyn, Vivian; Bussmann, Johannes B. J.

doi:10.1080/09638288.2020.1851781

Cited by 8 publications

(6 citation statements)

References 48 publications

(55 reference statements)

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“…As most of the total amount of physical activity involved walking, we focus our interpretation on walking intensity, which is closely linked to ambulatory walking speed. 41 We found walking intensity to be reduced by 6% in the mild stroke group, which is comparable to the reduction found in comfortable walking speed as measured in the laboratory setting with the 10-MWT. The lower walking intensity in the mild stroke group could be the consequence of their leg motor function impairment (ie, lower scores on the FM-LE), poorer balance capacity (ie, lower scores on mini-BEST), lower balance confidence or lower cardiovascular capacity.…”

Section: Discussionsupporting

confidence: 77%

Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity

Roelofs,

Zandvliet,

Schut

et al. 2023

Neurorehabil Neural Repair

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Background After mild stroke persistent balance limitations may occur, creating a risk factor for fear of falling, falls, and reduced activity levels. Objective. To investigate whether individuals in the chronic phase after mild stroke show balance and gait limitations, elevated fall risk, reduced balance confidence, and physical activity levels compared to healthy controls. Methods An observational case-control study was performed. Main outcomes included the Mini-Balance Evaluation Systems Test (mini-BEST), Timed Up and Go (TUG), 10-m Walking Test (10-MWT), and 6-item version Activity-specific Balance Confidence (6-ABC) scale which were measured in 1 session. Objectively measured daily physical activity was measured for 7 consecutive days. Fall rate in daily life was recorded for 12 months. Individuals after a mild stroke were considered eligible when they: (1) sustained a transient ischemic attack or stroke longer than 6 months ago, resulting in motor and/or sensory loss in the contralesional leg at the time of stroke, (2) showed (near-) complete motor function, that is, ≥24 points on the Fugl-Meyer Assessment—Lower Extremity (range: 0-28). Results Forty-seven healthy controls and 70 participants after mild stroke were included. Participants with stroke fell more than twice as often as healthy controls, had a 2 point lower median score on the mini-BEST, were 1.7 second slower on TUG, 0.6 km/h slower on the 10-MWT, and had a 12% lower 6-ABC score. Intensity for both total activity (8%) as well as walking activity (6%) was lower in the participants with stroke, while no differences were found in terms of duration. Conclusions Individuals in the chronic phase after a mild stroke demonstrate persistent balance limitations and have an increased fall risk. Our results point at an unmet clinical need in this population.

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Section: Discussionsupporting

confidence: 77%

Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity

Roelofs,

Zandvliet,

Schut

et al. 2023

Neurorehabil Neural Repair

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Section: Discussionmentioning

confidence: 99%

“…Physical inactivity is currently one of the major health problems worldwide, and sedentary behaviour is associated with an increased risk of obesity and a contribution to the development of cardiovascular diseases. 60 To aid weight reduction in emerging adults, it is advised that general suggestions be followed regarding a balanced diet and physical exercise. However, lifestyle therapies, such as calorie-restricted diets in general and low-fat or low-carbohydrate diets with or without increased PA, are often associated with poor adherence and high drop-out and relapse rates in young people.…”

Section: Discussionmentioning

confidence: 99%

Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial

Xu,

Tao,

Chen

et al. 2023

BMJ Open

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IntroductionA dramatic decline in physical activity may occur in emerging adulthood because of a major transition over the course of a life. The potential for implementing structured behaviour modification strategies to enhance risk-reducing clinical outcomes is widely recognised. The active participation of clients in the discussion and care process is crucial for optimising intervention outcomes and enhancing individuals’ motivation to adopt and maintain healthy behaviours. This study therefore aims to evaluate the effectiveness of a physical activity promotion programme based on the goal attainment theory in relation to emerging adults’ body composition, using a face-to-face and e-health blended interventions.Methods and analysisA two-arm, double-blind, randomised, controlled study will be conducted in 114 university students aged 18–25 years with physical inactivity. The intervention assignment will be blind to study participants, outcome assessors and study statisticians. A goal achievement theory-based physical activity promotion programme is developed in this study, which is a 16-week, face-to-face and e-health-blended physical activity promotion intervention. After informed consent, participants will be randomly assigned to either a control group or a treatment group before the start of the study. The primary outcome is body composition (ie, skeletal muscle mass, body fat mass, body mass index and body fat percentage). Other outcomes include physical activity level, goal attainment scale scores, exercise self-efficacy and motivation level, which will be assessed during the intervention (every 4 weeks) and at the 1 month follow-up. Continuous variables have means and SD, while categorical variables have frequencies and percentages. Independent-samples t-tests will be used to compare continuous variable changes. χ2tests will be used to compare categorical variable changes. Based on the baseline scores, analysis of covariance will compare the follow-up results.Ethics and disseminationThis study was approved by the Ethics Committee of Hangzhou Normal University (ratification date: 14 November 2022, 2022059). The results of the study will be submitted for publication and dissemination in a peer-reviewed journal.Trial registration numberNCT05697679.

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“…The output of the Activ8 monitor consists of time spent in six categories of body postures and movements (lying, sitting, standing, walking, running and cycling) within an epoch length of 30 s [ 14 ]. In each epoch, the number of movement counts is calculated for each category, representing the amount of movement within that epoch.…”

Section: Methodsmentioning

confidence: 99%

“…In contrast, other studies showed that the average walking time and the daily number of steps were significantly lower in stroke survivors [ 11 – 13 ]. It is increasingly recognized that PA is multidimensional, including dimensions such as Intensity, Frequency, Duration and Distribution [ 8 , 10 , 14 ]. Therefore, clinically relevant information on PA cannot be captured in one outcome and reporting multiple outcomes concurrently preferred [ 8 , 10 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Physical activity dimensions after stroke: patterns and relation with lower limb motor function

Braakhuis

Berger

Regterschot

et al. 2021

J NeuroEngineering Rehabil

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Background Stroke survivors show deteriorated physical functioning and physical activity levels. Physical activity levels of stroke survivors are generally low. It is increasingly recognized that physical activity is a multidimensional construct that cannot be captured in a single outcome. In-depth insight into multidimensional physical activity patterns may guide the development and timing of targeted rehabilitation interventions. This longitudinal cohort study explored how multidimensional physical activity outcomes develop during recovery in the subacute phase after stroke and if changes in physical activity were correlated to recovery of lower limb motor function. Methods Patients were recruited during inpatient rehabilitation. At 3, 12, and 26 weeks post-onset, motor function was measured by the Fugl-Meyer Lower Extremity Assessment (FMA-LE). Physical activity was measured with the Activ8 accelerometer in multiple outcomes: counts per minute during walking (CPMwalking; a measure of Intensity), number of active bouts (Frequency), mean length of active bouts (Distribution) and % of waking time in upright positions (Duration). Generalized estimating equations (GEE) were used to study changes in physical activity over time and the relation with the change in lower limb motor recovery. Results Thirty-nine patients (age 56 ± 9, 77% male, 89% ischemic stroke) were included. GEE models showed a significant main effect of time for PA Intensity (+ 13%, p = 0.007) and Duration (+ 64%, p = 0.012) between 3 and 12 weeks. Motor function did not show a significant effect in all PA models across the 3 timepoints (p > 0.020). A significant interaction effect of time × motor function was observed (p < 0.001). Conclusions Patterns of PA recovery depend on the PA dimensions: PA Intensity and Duration increased mostly between 3 and 12 weeks post-stroke, whereas Frequency and Distribution did not show substantial changes. Further, no strong associations with motor recovery and high inter-individual variability were documented, which underlies the need to consider factors specific to the disease, the individual patient and the context.

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Intensity of daily physical activity – a key component for improving physical capacity after minor stroke?

Cited by 8 publications

References 48 publications

Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity

Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity

Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial

Physical activity dimensions after stroke: patterns and relation with lower limb motor function

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