Movement behavior remains stable in stroke survivors within the first two months after returning home

Wondergem, Roderick; Pisters, Martijn F.; Heijmans, M.W.; Wouters, Eveline; Bie, Rob A. de; Veenhof, Cindy; Visser‐Meily, Johanna M. A.

doi:10.1371/journal.pone.0229587

Cited by 11 publications

(3 citation statements)

References 65 publications

(82 reference statements)

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“…In line with prior studies, the current data show that stroke survivors are predominantly sedentary and engage in little moderate to vigorous PA (34,35). The current findings are similar to those of the study of Wondergem et al (36), who reported SB and PA levels from free-living stroke survivors in the first 2 months post-stroke. Compared with the few other studies that have objectively assessed levels of SB and PA (35,37) among stroke survivors, the current study population appears to be more physically active, on average, in terms of less time spent sedentary and more time spent in moderate PA. After adjustments for probable factors affecting PA post-stroke, this study found no significant relationship between SB, PA, and mood.…”

Section: Discussionsupporting

confidence: 92%

Accelerometer-measured physical activity at 3 months as a predictor of symptoms of depression and anxiety 1 year after stroke: a multicentre prospective cohort study in central Norway

Phan,

Askim,

Lydersen

et al. 2023

JRM

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Objectives: To study sedentary behaviour and physical activity at 3 months as predictors for symptoms of depression and anxiety at 1-year post-stroke. Design: A prospective cohort study. Patients: Patients with first-ever ischaemic stroke. Methods: Mood was assessed 3- and 12-months post-stroke using the Hospital Anxiety and Depression Scale. Sedentary behaviour and physical activity were measured using accelerometry 3 months post-stroke. Results: A total of 292 participants (116 (39.7%) females; mean age 71.7 (standard deviation 11.3) years) were included. At 12 months, 16.7% experienced depression and 19.5% anxiety, respectively. Adjusting for age and sex, regression analysis showed that comorbidity burden (β 0.26; 95% confidence interval (95% CI) 0.02, 0.51; p = 0.038), stroke severity (β 0.22; 95% CI 0.10, 0.35; p = 0.001), functional disability (β 0.89, 95% CI 0.49, 1.30; p = 0.000), and global cognition (β–0.15; 95% CI –0.25, –0.05; p = 0.004) predicted depression. Multi-adjusted analysis showed sedentary behaviour and physical activity did not significantly predict depression or anxiety (p > 0.05). Conclusion: Sedentary behaviour and physical activity did not significantly predict mood after stroke. Comorbidity burden, stroke severity, functional disability, and global cognition were identified as possible predictors of depression. More research is needed to determine the impact of physical activity on depression and anxiety symptoms.

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Section: Discussionsupporting

confidence: 92%

Accelerometer-measured physical activity at 3 months as a predictor of symptoms of depression and anxiety 1 year after stroke: a multicentre prospective cohort study in central Norway

Phan,

Askim,

Lydersen

et al. 2023

JRM

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“…40 In this study movement behavior patterns were objectified in the first three weeks after returning home. Although movement behavior outcomes remain stable within the first two months after returning home in people with a first ever-stroke, 41 individuals change movement behavior patterns. Therefore, future research should determine if individuals' membership changes in movement behavior patterns within the first year after discharge to home.…”

Section: Discussionmentioning

confidence: 98%

The course of physical functioning in the first two years after stroke depends on peoples’ individual movement behavior patterns

Wondergem

Pisters

Wouters

et al. 2021

International Journal of Stroke

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Background and purpose: Deterioration of physical functioning after stroke in the long term is regarded as a major problem. Currently, the relationship between 'peoples' movement behavior patterns (the composition of sedentary behavior and physical activity during waking hours) directly after stroke and the development of physical functioning over time is unknown. Therefore, the objectives of this study were to investigate 1) the course of physical functioning within the first two years after returning home after stroke and 2) the association between physical functioning and baseline movement behavior patterns. Method: In the longitudinal RISE cohort study, 200 persons with a first-ever stroke discharged to the home-setting were included. 'Participants' physical functioning was assessed within three weeks, at six months, and one and two years after discharge using the Stroke Impact Scale (SIS) 3.0 subscale physical and the five-meter walk test (5MWT). Three distinct movement behavior patterns were identified in a previous study at baseline and were used in the current study: 1. 'sedentary 'exercisers' (sufficiently active and 64% of waking hours sedentary), 2. 'sedentary 'movers' (inactive and sedentary 63% of waking hours sedentary), and 3. 'sedentary 'prolongers' (inactive and >78% of waking hours sedentary accumulated in long prolonged bouts). The association between movement behavior patterns and the course of physical functioning was determined using longitudinal generalized estimating equations analyses. Results: Overall participants' physical functioning increased between discharge and six months and declined from six months up to two years. Physical functioning remained stable during the first two years after stroke in 'sedentary 'exercisers'. Physical functioning improved during the first six months after discharge in 'sedentary 'movers' and 'sedentary 'prolongers' and deteriorated in the following six months. Only physical functioning (SIS) of 'sedentary 'prolongers' further declined from one up to two years. A similar pattern was observed in the 5MWT. Conclusion: Movement behavior patterns identified directly after returning home in people with stroke are associated with and are predictive of the course of physical functioning. Highly sedentary and inactive people with stroke have unfavorable outcomes over time than individuals with higher amounts of physical activity.

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“…3 Behavioural change and environmental approaches are effective in reducing sedentary behaviour, 4,5 but published studies on the effectiveness from discharge until follow-up are few, and evidence is sparse. 6 Since sedentary behaviour is more common in patients with minor ischeamic stroke than in healthy individuals, 7 it is necessary to clarify the effectiveness of approaches to reduce sedentary behaviour in this cohort. Although we previously established the effectiveness of an approach to promote the reduction of sedentary behaviour in patients with minor ischaemic stroke, 8 the sample size was small, suggesting the need for further study.…”

Section: Introductionmentioning

confidence: 99%

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

et al. 2022

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Objectives To determine the effects on sedentary behaviour of an approach that promotes reduction in sedentary behaviour in patients with minor ischaemic stroke after intervention and at follow-up. Design A randomised controlled trial. Setting During hospitalisation and after hospital discharge Subjects In total, 86 patients with minor ischaemic stroke admitted to an acute care hospital were assigned to the intervention (n = 43) and control (n = 43) groups. Intervention An intervention group that received an approach to reduce sedentary behaviour upon hospital admission until 3 months after discharge (education, self-monitoring, phone calls, etc.) and a control group that received the usual care during hospitalisation. From 3 to 6 months after discharge, no group received any intervention. Main Outcome The primary outcome was the change (%) in sedentary behaviour from baseline to post-intervention (3 months after discharge) and follow-up (6 months after discharge). Sedentary behaviour was measured at baseline (upon hospital admission), post-intervention, and at follow-up using accelerometers. Results At the post-intervention stage, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −22.7%; control group, −14.9%; P = 0.013; effect size = 0.58). At follow-up too, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −20.4%; control group, −13.6%; P = 0.025; effect size = 0.54). Conclusions An approach to reduce sedentary behaviour in patients with minor ischaemic stroke effectively reduces sedentary behaviour, which is sustained up to follow-up. Trial registration This study is registered at www.umin.ac.jp/ctr/index/htm UMIN000038616.

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Movement behavior remains stable in stroke survivors within the first two months after returning home

Cited by 11 publications

References 65 publications

Accelerometer-measured physical activity at 3 months as a predictor of symptoms of depression and anxiety 1 year after stroke: a multicentre prospective cohort study in central Norway

Accelerometer-measured physical activity at 3 months as a predictor of symptoms of depression and anxiety 1 year after stroke: a multicentre prospective cohort study in central Norway

The course of physical functioning in the first two years after stroke depends on peoples’ individual movement behavior patterns

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

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