The course of physical functioning in the first two years after stroke depends on peoples' individual movement behavior patterns
Wondergem, Roderick; Pisters, Martijn F; Wouters, Eveline Jm; de Bie, Rob A; Veenhof, Cindy; Visser-Meily, Johanna Ma
(2022) International Journal of Stroke, volume 17, issue 1, pp. 83 - 92
(Article)
Abstract
BACKGROUND AND PURPOSE: Deterioration of physical functioning after stroke in the long term is regarded as a major problem. Currently, the relationship between "peoples'" movement behavior patterns (the composition of sedentary behavior and physical activity during waking hours) directly after stroke and the development of physical functioning over time is
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unknown. Therefore, the objectives of this study were to investigate (1) the course of physical functioning within the first two years after returning home after stroke, and (2) the association between physical functioning and baseline movement behavior patterns. METHOD: In the longitudinal RISE cohort study, 200 persons with a first-ever stroke discharged to the home-setting were included. Participants' physical functioning was assessed within three weeks, at six months, and one and two years after discharge using the Stroke Impact Scale (SIS) 3.0 subscale physical and the five-meter walk test (5MWT). Three distinct movement behavior patterns were identified in a previous study at baseline and were used in the current study: (1) sedentary exercisers (sufficiently active and 64% of waking hours sedentary), (2) sedentary movers' (inactive and 63% of waking hours sedentary), and (3) sedentary prolongers (inactive and >78% of waking hours sedentary accumulated in long prolonged bouts). The association between movement behavior patterns and the course of physical functioning was determined using longitudinal generalized estimating equations analyses. RESULTS: Overall participants' physical functioning increased between discharge and six months and declined from six months up to two years. Physical functioning remained stable during the first two years after stroke in sedentary exercisers. Physical functioning improved during the first six months after discharge in sedentary movers and sedentary prolongers and deteriorated in the following six months. Only physical functioning (SIS) of sedentary prolongers further declined from one up to two years. A similar pattern was observed in the 5MWT. CONCLUSION: Movement behavior patterns identified directly after returning home in people with stroke are associated with and are predictive of the course of physical functioning. Highly sedentary and inactive people with stroke have unfavorable outcomes over time than individuals with higher amounts of physical activity.
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Keywords: movement behavior, physical activity, physical functioning, secondary prevention, sedentary behavior, Stroke, Neurology, Journal Article
ISSN: 1747-4930
Publisher: Blackwell Publishing Asia Pty Ltd
Note: Funding Information: We would like to thank all participants for their contribution to the RISE-study. Furthermore, we would like to thank the staff of Catharina Hospital (Eindhoven), Jeroen Bosch Ziekenhuis (?s Hertogenbosch), Maxima Medisch Centrum (Veldhoven) and Sint-Jans Gasthuis (Weert), and we would like to thank Thirsa Koebrugge and Joeri Polman, who helped with the data collection. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Netherlands Organization for Scientific Research (NWO), Doctoral grant for Teachers, 023.003.136. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Netherlands Organization for Scientific Research (NWO), Doctoral grant for Teachers, 023.003.136. Acknowledgements Publisher Copyright: © 2021 World Stroke Organization.
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