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Physical activity dimensions after stroke: patterns and relation with lower limb motor function
BACKGROUND: Stroke survivors show deteriorated physical functioning and physical activity levels. Physical activity levels of stroke survivors are generally low. It is increasingly recognized that physical activity is a multidimensional construct that cannot be captured in a single outcome. In-depth...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666008/ https://www.ncbi.nlm.nih.gov/pubmed/34895265 http://dx.doi.org/10.1186/s12984-021-00960-x |
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author | Braakhuis, Hanneke E. M. Berger, Monique A. M. Regterschot, Ruben G. R. H. van Wegen, Erwin E. H. Selles, Ruud W. Ribbers, Gerard M. Bussmann, Johannes B. J. |
author_facet | Braakhuis, Hanneke E. M. Berger, Monique A. M. Regterschot, Ruben G. R. H. van Wegen, Erwin E. H. Selles, Ruud W. Ribbers, Gerard M. Bussmann, Johannes B. J. |
author_sort | Braakhuis, Hanneke E. M. |
collection | PubMed |
description | BACKGROUND: Stroke survivors show deteriorated physical functioning and physical activity levels. Physical activity levels of stroke survivors are generally low. It is increasingly recognized that physical activity is a multidimensional construct that cannot be captured in a single outcome. In-depth insight into multidimensional physical activity patterns may guide the development and timing of targeted rehabilitation interventions. This longitudinal cohort study explored how multidimensional physical activity outcomes develop during recovery in the subacute phase after stroke and if changes in physical activity were correlated to recovery of lower limb motor function. METHODS: Patients were recruited during inpatient rehabilitation. At 3, 12, and 26 weeks post-onset, motor function was measured by the Fugl-Meyer Lower Extremity Assessment (FMA-LE). Physical activity was measured with the Activ8 accelerometer in multiple outcomes: counts per minute during walking (CPM(walking); a measure of Intensity), number of active bouts (Frequency), mean length of active bouts (Distribution) and % of waking time in upright positions (Duration). Generalized estimating equations (GEE) were used to study changes in physical activity over time and the relation with the change in lower limb motor recovery. RESULTS: Thirty-nine patients (age 56 ± 9, 77% male, 89% ischemic stroke) were included. GEE models showed a significant main effect of time for PA Intensity (+ 13%, p = 0.007) and Duration (+ 64%, p = 0.012) between 3 and 12 weeks. Motor function did not show a significant effect in all PA models across the 3 timepoints (p > 0.020). A significant interaction effect of time × motor function was observed (p < 0.001). CONCLUSIONS: Patterns of PA recovery depend on the PA dimensions: PA Intensity and Duration increased mostly between 3 and 12 weeks post-stroke, whereas Frequency and Distribution did not show substantial changes. Further, no strong associations with motor recovery and high inter-individual variability were documented, which underlies the need to consider factors specific to the disease, the individual patient and the context. |
format | Online Article Text |
id | pubmed-8666008 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86660082021-12-13 Physical activity dimensions after stroke: patterns and relation with lower limb motor function Braakhuis, Hanneke E. M. Berger, Monique A. M. Regterschot, Ruben G. R. H. van Wegen, Erwin E. H. Selles, Ruud W. Ribbers, Gerard M. Bussmann, Johannes B. J. J Neuroeng Rehabil Research BACKGROUND: Stroke survivors show deteriorated physical functioning and physical activity levels. Physical activity levels of stroke survivors are generally low. It is increasingly recognized that physical activity is a multidimensional construct that cannot be captured in a single outcome. In-depth insight into multidimensional physical activity patterns may guide the development and timing of targeted rehabilitation interventions. This longitudinal cohort study explored how multidimensional physical activity outcomes develop during recovery in the subacute phase after stroke and if changes in physical activity were correlated to recovery of lower limb motor function. METHODS: Patients were recruited during inpatient rehabilitation. At 3, 12, and 26 weeks post-onset, motor function was measured by the Fugl-Meyer Lower Extremity Assessment (FMA-LE). Physical activity was measured with the Activ8 accelerometer in multiple outcomes: counts per minute during walking (CPM(walking); a measure of Intensity), number of active bouts (Frequency), mean length of active bouts (Distribution) and % of waking time in upright positions (Duration). Generalized estimating equations (GEE) were used to study changes in physical activity over time and the relation with the change in lower limb motor recovery. RESULTS: Thirty-nine patients (age 56 ± 9, 77% male, 89% ischemic stroke) were included. GEE models showed a significant main effect of time for PA Intensity (+ 13%, p = 0.007) and Duration (+ 64%, p = 0.012) between 3 and 12 weeks. Motor function did not show a significant effect in all PA models across the 3 timepoints (p > 0.020). A significant interaction effect of time × motor function was observed (p < 0.001). CONCLUSIONS: Patterns of PA recovery depend on the PA dimensions: PA Intensity and Duration increased mostly between 3 and 12 weeks post-stroke, whereas Frequency and Distribution did not show substantial changes. Further, no strong associations with motor recovery and high inter-individual variability were documented, which underlies the need to consider factors specific to the disease, the individual patient and the context. BioMed Central 2021-12-11 /pmc/articles/PMC8666008/ /pubmed/34895265 http://dx.doi.org/10.1186/s12984-021-00960-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Braakhuis, Hanneke E. M. Berger, Monique A. M. Regterschot, Ruben G. R. H. van Wegen, Erwin E. H. Selles, Ruud W. Ribbers, Gerard M. Bussmann, Johannes B. J. Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title | Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title_full | Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title_fullStr | Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title_full_unstemmed | Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title_short | Physical activity dimensions after stroke: patterns and relation with lower limb motor function |
title_sort | physical activity dimensions after stroke: patterns and relation with lower limb motor function |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666008/ https://www.ncbi.nlm.nih.gov/pubmed/34895265 http://dx.doi.org/10.1186/s12984-021-00960-x |
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