Physical Activity and Sedentary Behaviors in People With Stroke Living in the Community: A Systematic Review

English, Coralie; Manns, Patricia J.; Tucak, Claire; Bernhardt, Julie

doi:10.2522/ptj.20130175

Cited by 208 publications

(181 citation statements)

References 51 publications

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“…The results of this study have shown that ambulatory subacute stroke patients have a significantly lower PA level than that of a population of It is well known that a sustained decline in PA is common among stroke patients in the chronic term (29). It is also known that the PA levels of stroke patients are low in acute stroke wards (12,30).…”

Section: Discussionmentioning

confidence: 70%

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Hüseyinsinoğlu

Aslan

Tarakçı

et al. 2017

Arch Neuropsychiatr

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Introduction: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group.Methods: Eighty-five subacute stroke patients and 58 healthy subjects were included. Patients' demographic features, disease-related features, and comorbidities were recorded. The PA level was assessed by the International Physical Activity Questionnaire-Short Version and a pedometer (OMRON Walking style II). The Apathy Rating Scale was applied to determine the apathy level. Depression level was investigated by the Geriatric Depression Scale. The standardized Mini-mental State Examination was performed to assess the cognitive status.Results: The PA level was significantly higher in the healthy group than in the stroke group (p<0.001).Step count and walking distance were significantly higher in healthy group (p=0.001 and p=0.04, respectively). The PA level of men was significantly higher than that of women (p=0.03). Participants who were classified as level 4 had a lower PA level than those who were classified as level 5 according to the Functional Ambulation Category. There was no relationship between the PA level and the apathy, cognitive, and depression levels in the stroke patients (p>0.05). Conclusion:Subacute stroke patients have a lower PA level than healthy subjects. This is not related to neuropsychological factors. The reasons for minor deficits related to ambulation should be researched further while developing strategies for increasing the PA level of subacute stroke patients.Keywords: Stroke, apathy, depression, cognition, physical activity ABSTRACT 155level cannot be explained only by loss of motor function, psychological and cognitive factors have been proposed to analyze (13,14). In light of these findings, we aimed to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate the demographic features and disease-related and neuropsychological factors that could affect the PA level in the same stroke group. We hypothesized that the PA level of ambulatory subacute stroke patients would be less than that of healthy subjects. We further hypothesized that the PA level would be affected by neuropsychological factors in the same population.

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Section: Discussionmentioning

confidence: 70%

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Hüseyinsinoğlu

Aslan

Tarakçı

et al. 2017

Arch Neuropsychiatr

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“…It is possible that prolonged sitting and sedentary behaviours start early after stroke survivors return home. In future, investigation of activity behaviours after stroke should also include measurement of sedentary behaviours such as sitting 2,27 and physical activity interventions should also target reducing daily sitting time to reduce risk of chronic disease in this group 28 .…”

Section: Discussionmentioning

confidence: 99%

“…However, by the chronic phase of recovery, stroke survivors commonly adopt sedentary activity behaviours 2 . For example, after stroke, daily step counts are reported to range from 1400 3 to 6195 4 steps/day, indicating that the overall volume of activity after stroke is mostly below that required for general health benefits (i.e.…”

Section: Introductionmentioning

confidence: 99%

Recovery of ambulation activity across the first six months post-stroke

2016

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word count: 245 Word count: 2754 Highlights Stroke survivors increase walking activity over the first 6 months post-discharge.  Stroke survivors increase daily sitting time over the first 6-monts post-discahrge.  Stroke survivors spend least time in long duration and high intensity activity.  Interventions to target activity should be considered 3-months post-discharge. AbstractStroke survivors commonly adopt sedentary activity behaviours by the chronic phase of recovery. However, the change in activity behaviours from the subacute to chronic phase of stroke is variable. This study explored the recovery of ambulation activity (volume and bouts) at one, three and six months after hospital discharge post-stroke. A total of 42 stroke survivors were recruited at hospital discharge and followed up one, three and six months later. At follow-up, ambulation activity was measured over four days using the ActivPAL TM accelerometer. Measures included volume of activity and frequency and intensity of ambulation activity bouts per day. Linear mixed effects modelling was used to determine changes over time. There was wide variation in activity. Total step counts across all time points were below required levels for health benefits (mean 4592 SD 3411). Most activity was spread across short bouts. While most number of bouts was of low intensity, most time was spent in moderate intensity ambulation across all time points. Daily step count and time spent walking and sitting/lying increased from one month to three and six months. The number of and time spent in short and medium duration bouts increased from one to six months. Time in long duration bouts increased at three months only. Time spent in moderate intensity ambulation increased over time. No change was observed for any other measures. In future, it would be valuable to identify strategies to increase engagement in activity behaviours to improve health outcomes after stroke.

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“…This shift in thinking creates measurement challenges, since sedentary behaviour in people with stroke has been traditionally measured in a number of ways, both subjectively and objectively. Subjectively, sedentary behaviour has most frequently been measured by self-report using activity questionnaires [14]. Objectively, accelerometers have become the standard method of measurement to collect information regarding the intensity of movement [15].…”

Section: Sedentary Behaviour In People With Stroke?mentioning

confidence: 99%

Sedentary Behaviour and Stroke: Foundational Knowledge is Crucial

Verschuren

Mead

Visser‐Meily

2014

Transl. Stroke Res.

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Physical activity is important for people's health. The emphasis over the last two decades has been on moderate to vigorous exercise when designing activity and exercise programmes for adults with stroke. Emerging evidence suggests that sedentary behaviour is distinctly different from a lack of moderate to vigorous physical activity and has independent and different physiological mechanisms. In the general population, reduced physical activity is associated with a shorter life expectancy and a higher risk of developing type II diabetes, cardiovascular disease and some types of cancer [1,2]. To reduce these risks, guidelines recommend at least 30 min of moderate-intensity physical activity on at least five days a week [2]. For decades, exercise professionals have promoted moderate-to vigorous-intensity levels of physical activity.Stroke rehabilitation often focuses on improving or maintaining the aerobic fitness level, improving cerebrovascular health and brain perfusion. For the prevention of recurrent stroke and acute cardiac events in stroke survivors, modification of multiple risk factors is recognized as the cornerstone of initiatives. Physical activity can modify several predisposing vascular risk factors like high blood pressure, abnormal blood lipids, HDL cholesterol, obesity and diabetes mellitus [3]. So, it is no surprise that the American Heart Association recommends that stroke survivors should participate in structured physical activity programmes to improve health [4].Although it is well-established that physical activity is important for one's health, recent evidence suggests that this is only part of the story. Sedentary behaviour and physical activity had previously been seen as two sides of the same coin. They are, however, different constructs in the activity continuum and have independent effects on health. Recent studies have consistently shown that a large amount of sedentary behaviour, as distinct from a lack of moderate to vigorous physical activity, is also associated with an increased risk of coronary heart disease, hypertension, diabetes, obesity, mortality and some cancers in the general population [5,6]. Sedentary behaviour is characterized as any behaviour with extremely low-energy cost. Activity-related energy expenditure is quantified using metabolic equivalents of tasks (METs) [7]. The adverse health outcomes associated with sedentary behaviour (i.e. sitting/reclining) are independent of the total amount of moderate to vigorous physical activity performed [8]. It is increasingly clear that the amount of sedentary behaviour people engage in has a large impact on health, regardless of their level of physical activity [8]. It is therefore no surprise that the interest in decreasing sedentary behaviour

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Physical Activity and Sedentary Behaviors in People With Stroke Living in the Community: A Systematic Review

Cited by 208 publications

References 51 publications

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Recovery of ambulation activity across the first six months post-stroke

Sedentary Behaviour and Stroke: Foundational Knowledge is Crucial

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