Physical activity in chronic home-living and sub-acute hospitalized stroke patients using objective and self-reported measures

Vanroy, Christel; Vissers, Dirk; Vanlandewijck, Yves; Feys, Hilde; Truijen, Steven; Michielsen, Marc; Cras, Patrick

doi:10.1080/10749357.2015.1116227

“…A majority of participants were rather physically inactive, as shown by their PASE-scores [33] (see Table 1). This is confirmed by existing literature, which showed that PA participation among persons with stroke is normally lower compared with a general population [36, 37], and that persons with stroke spend more time sitting and less time in activity than age-matched peers [9]. Most of the participants did not distinguish between general physical activity and planned exercise, these terms were used interchangeably.…”

Section: Discussionsupporting

confidence: 78%

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

Törnbom

¹

,

Sunnerhagen

²

,

Danielsson

³

2017

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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.

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“…The strengths of this study are its large sample size, its broad inclusion criteria, the use of accelerometers to assess PA and the large number of PA hours recorded. Regarding sample size, this study is the largest when compared to other studies in Europe (12,13,(16)(17)(18)41), the USA (20,21,32) and Australia (14,19). Regarding inclusion criteria, and contrary to previous studies (12,32,47,48), we included patients with cognitive impairment/confusion as they are at increased risk of post-hospitalization functional decline (28,39).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Further, the data collected can be analyzed with algorithms that classify locomotion and nonlocomotion periods in everyday life (15). Still, there is a paucity of studies assessing PA levels by accelerometry in hospitalized older patients (12)(13)(14)(16)(17)(18)(19)(20)(21)(22). In a previous paper, Lim et al reported that the PA levels of 38 hospitalized older patients were very low and that most PA was sustained over short periods (12).…”

Section: Introductionmentioning

confidence: 99%

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Tasheva

¹

,

Kraege

²

,

Vollenweider

³

et al. 2020

Preprint

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Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

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“…The strengths of this study are its large sample size, its broad inclusion criteria, the use of accelerometers to assess PA and the large number of PA hours recorded. Regarding sample size, this study is the largest when compared to other studies in Europe (12,13,(16)(17)(18)41), the USA (20,21,32) and Australia (14,19).…”

Section: Strengths and Limitationsmentioning

confidence: 94%

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Tasheva

¹

,

Kraege

²

,

Vollenweider

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

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Physical activity in chronic home-living and sub-acute hospitalized stroke patients using objective and self-reported measures

Cited by 25 publications

References 30 publications

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

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

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

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