Physical Activity, Sedentary Behaviour and Metabolic Control following Stroke: A Cross-Sectional and Longitudinal Study

Moore, Sarah A.; Hallsworth, Kate; Plötz, Thomas; Ford, Gary A.; Rochester, Lynn; Trenell, Michael I.

doi:10.1371/journal.pone.0055263

Cited by 118 publications

(129 citation statements)

References 25 publications

Supporting

Mentioning

115

Contrasting

Order By: Relevance

“…Contrary to previous reports of a plateau in ambulation activity recovery at six months 7 , the current study demonstrated a greater improvement in ambulation activity between one and six months than between one and three months after hospital discharge. These findings may be due to the different statistical methods employed in the current study (e.g.…”

Section: Discussioncontrasting

confidence: 99%

“…This study contributes to the limited findings on ambulation recovery across the subacute phase of stroke, providing further evidence that volume of activity can improve over this time 6,7 . Contrary to previous reports of a plateau in ambulation activity recovery at six months 7 , the current study demonstrated a greater improvement in ambulation activity between one and six months than between one and three months after hospital discharge.…”

Section: Discussionmentioning

confidence: 65%

“…10,000 steps per day) 5 . However, observation of change in ambulation activity behaviours from the subacute (24 hours to 6-months post-stroke) to the chronic phase (> 6-months post-stroke) of stroke recovery is limited and variable 4,6,7 .…”

Section: Introductionmentioning

confidence: 99%

“…These studies report a range of findings, from no change in daily step counts across six weeks after hospital discharge post-stroke 4 , to improvements of approximately 1200 steps/day (80% increase) across twelve weeks after hospital discharge 6,7 , with little change in daily ambulation activity after this time 7 . This variation in the literature is likely due to many factors, including the devices used, the time points chosen and measures used to characterise activity.…”

Section: Introductionmentioning

confidence: 99%

“…When measures are examined, device-based measurement of ambulation activity after stroke has traditionally been characterised by measures of volume such as daily step counts 3,4,7,8 , activity duration 9,10 and estimated energy expenditure 7 . However more recently, the importance of capturing the spread of activity across the day has been highlighted 11 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

2016

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

2016

View full text Add to dashboard Cite

show abstract

Physical Activity Trajectories and Functional Recovery After Acute Stroke Among Adults in Sweden

et al. 2023

View full text Add to dashboard Cite

ImportanceThe optimum level and timing of poststroke physical activity interventions to enhance functional recovery remain unclear.ObjectiveTo assess the level of physical activity in the first 6 months after stroke among individuals with similar physical activity patterns over time and to investigate the association between physical activity trajectories and functional recovery at 6 months after stroke.Design, Setting, and ParticipantsThis cohort study obtained data from the Efficacy of Fluoxetine–a Randomized Controlled Trial in Stroke, which was conducted in 35 stroke and rehabilitation centers across Sweden from October 2014 to June 2019. Adult participants (aged &gt;18 years) were recruited between 2 and 15 days after stroke onset and followed up for 6 months. Participants who withdrew or were lost to follow-up were excluded from the longitudinal analysis. Data analyses were performed between August 15 and October 28, 2022.ExposuresPhysical activity was assessed at 1 week, 1 month, 3 months, and 6 months. Multiple factors associated with physical activity trajectories were investigated. Association of the distinct trajectories with functional recovery was assessed in multivariable logistic regression.Main Outcomes and MeasuresThe primary outcomes were the distinct physical activity trajectories over time, which were identified using group-based trajectory modeling. The secondary outcome was the functional recovery at 6 months after stroke, which was assessed using the modified Rankin Scale.ResultsOf the 1367 included participants (median [IQR] age, 72 years [65-79] years; 844 males [62%]), 2 distinct trajectory groups were identified: increaser (n = 720 [53%]) and decreaser (647 [47%]). The increaser group demonstrated a significant increase in physical activity level (mean difference, 0.27; linear slope β1 = 0.46; P &lt; .001) and sustained it at light intensity from 1 week to 6 months, whereas the decreaser group showed a decline in physical activity and eventually became inactive (mean difference, −0.26; linear slope β1 = 1.81; P &lt; .001). Male participants and those with normal cognition had higher odds of being in the increaser group, regardless of stroke severity. Increasing physical activity and sustaining it at light intensity were associated with a good functional outcome at 6 months (adjusted odds ratio, 2.54; 99% CI, 1.72-3.75; P &lt; .001).Conclusions ad RelevanceResults of this study suggest that increased physical activity was associated with functional recovery 6 months after stroke. Interventions targeting individuals with decreasing physical activity in the subacute phase of stroke may play a role in improved functional outcomes.

show abstract

Physical fitness interventions for nonambulatory stroke survivors: A mixed‐methods systematic review and meta‐analysis

et al. 2018

View full text Add to dashboard Cite

IntroductionPhysical fitness training after stroke is recommended in guidelines across the world, but evidence pertains mainly to ambulatory stroke survivors. Nonambulatory stroke survivors (FAC score ≤2) are at increased risk of recurrent stroke due to limited physical activity. This systematic review aimed to synthesize evidence regarding case fatality, effects, experiences, and feasibility of fitness training for nonambulatory stroke survivors.MethodsEight major databases were searched for any type of study design. Two independent reviewers selected studies, extracted data, and assessed study quality, using published tools. Random‐effects meta‐analysis was used. Following their separate analysis, qualitative and quantitative data were synthesized using a published framework.ResultsOf 13,614 records, 33 studies involving 910 nonambulatory participants met inclusion criteria. Most studies were of moderate quality. Interventions comprised assisted walking (25 studies), cycle ergometer training (5 studies), and other training (3 studies), mainly in acute settings. Case fatality did not differ between intervention (1.75%) and control (0.88%) groups (95% CI 0.13–3.78, p = 0.67). Compared with control interventions, assisted walking significantly improved: fat mass, peak heart rate, peak oxygen uptake and walking endurance, maximum walking speed, and mobility at intervention end, and walking endurance, balance, mobility, and independent walking at follow‐up. Cycle ergometry significantly improved peak heart rate, work load, peak ventilation, peak carbon dioxide production, HDL cholesterol, fasting insulin and fasting glucose, and independence at intervention end. Effectiveness of other training could not be established. There were insufficient qualitative data to draw conclusions about participants' experiences, but those reported were positive. There were few intervention‐related adverse events, and dropout rate ranged from 12 to 20%.ConclusionsFindings suggest safety, effectiveness, and feasibility of adapted fitness training for screened nonambulatory stroke survivors. Further research needs to investigate the clinical and cost‐effectiveness as well as experiences of fitness training—especially for chronic stroke survivors in community settings.

show abstract

Physical Activity, Sedentary Behaviour and Metabolic Control following Stroke: A Cross-Sectional and Longitudinal Study

Cited by 118 publications

References 25 publications

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

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

Physical Activity Trajectories and Functional Recovery After Acute Stroke Among Adults in Sweden

Physical fitness interventions for nonambulatory stroke survivors: A mixed‐methods systematic review and meta‐analysis

Contact Info

Product

Resources

About