Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury

Abstract

BackgroundPhysical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury.MethodA qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively.ResultsPhysical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings.ConclusionPersons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase.

Relationships of Linear and Non-linear Measurements of Post-stroke Walking Activity and Their Relationship to Weather

“…However, no relationship between season and steps indicates that more research is needed to determine if the significant step-complexity relationship could be utilized to motivate patients based on activity intensity as a way to increase activity amount during seasons in which weather may pose a barrier to activity. Interestingly, stroke survivors have been found to self-report "bad weather" as a barrier to the amount of physical activity performed, but especially the kind of unfavorable conditions that involve precipitation and increased risk of falling (Törnbom et al, 2017), but that relationship was not shown in our data; we did not see an effect of precipitation on walking activity. Perhaps the lack of precipitation relationship may mean the effect of weather may be more related to temperature; spring temperatures are mild, whereas winter temperatures are cold in the study population's region (Climate-Data.org).…”

Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial

“…19 However, stroke survivors face considerable barriers to regular engagement in exercise. 20,21 Self-report data from the North-East Melbourne Stroke Incidence Study show that only 18% of stroke survivors are exercising regularly at five years after stroke. 22 Reducing time spent in uninterrupted sitting by introducing frequent short bouts of light-intensity physical activity during the day may be an alternative therapeutic target rather than, or in addition to, a program of moderate-intensity exercise.…”

The long-term effects of an implantable drop foot stimulator on gait in hemiparetic patients

“…As compensation is often insufficient or inefficient, patients tend to drag the hemiparetic foot across the ground with a high risk of falls [8, 9]. Additionally, the abnormal gait pattern leads to slower walking speed and, together with the increased risk of fall [10], they cause a reduced feeling of safety, necessitating the use of walking aids [11]. Compensatory mechanisms may also cause additional physical defects, including overuse symptoms due to increased activity in other muscle groups (such as tibialis posterior, flexor hallucis and digitorum, semitendinosus and semimembranosus) [12].…”