Adherence to physical activity and cardiovascular recommendations during the 2 years after stroke rehabilitation discharge - 24/03/21
, Julie Bernhardt d, Leonid Churilov e, Rebecca Clark a, Anne E. Holland a, b, f
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Highlights |
• | This study has the longest follow-up period of objectively measured physical activity in more than 50 stroke survivors. |
• | Physical activity levels were low throughout the 2-year follow-up, with no change over time observed. |
• | Adherence to cardiovascular risk recommendations decreased over time. |
• | BMI and waist circumference significantly increased over time. |
• | Ongoing multidisciplinary reviews post-stroke would be valuable to identify increased cardiovascular risk and facilitate initiation of appropriate interventions. |
Abstract |
Background |
Objective measurement is essential to represent habitual physical activity. To date only one study has objectively measured physical activity for>12months after stroke.
Objectives |
This study aimed to measure physical activity, cardiovascular risk factors, mobility, mood, fatigue and cognition during the 2years after rehabilitation discharge and to investigate whether stroke survivors meet physical activity and cardiovascular risk recommendations.
Methods |
This was a longitudinal observational study. Survivors of a first-ever stroke admitted to a large metropolitan rehabilitation hospital were recruited. Outcomes were measured at rehabilitation discharge and 6, 12 and 24months later. Outcomes were physical activity measured by the SenseWear Armband (e.g., moderate-vigorous physical activity, steps/day) and cardiovascular risk factors (e.g., blood pressure, fasting lipid profile and plasma glucose, waist circumference, body mass index), mobility, mood, fatigue and cognition. Changes over time were evaluated with random-effects regression modelling.
Results |
Participants (n=79, 33% female) had mean (SD) age of 65 (14) years and median gait speed 1.2m/s (interquartile range: 0.8–1.4) at baseline. We found no change in physical activity levels over time. Step count and time spent in bouts of moderate-vigorous physical activity remained low. Many participants achieved the recommended 30min of daily moderate-vigorous physical activity at baseline, but this was decreased at 2years (72% [57/79] versus 65% [37/57]). Adherence to cardiovascular recommendations decreased over time, notably for body mass index, plasma glucose and triglyceride levels. Waist circumference and body mass index increased at each time point relative to baseline (by a mean of 3.2cm and 1.2kg.m2, respectively, at 2years, P<0.01).
Conclusions |
This is the largest longitudinal study of objectively measured physical activity after stroke. Adherence to cardiovascular risk recommendations decreased over time post-stroke, and physical activity levels remained low. Stroke survivors may benefit from annual multidisciplinary reviews to identify increasing risk and initiate appropriate interventions.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Physical activity, Stroke, Cardiovascular, Adherence, Recommendations, Longitudinal
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| ☆ | Study conducted in the Physiotherapy Department at Caulfield Hospital, Alfred Health, Melbourne, Australia. |
Vol 64 - N° 2
Articolo 101455- marzo 2021 Ritorno al numero
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