Abstract TMP26: Density of Physical Activity Resources is Associated With Post-Stroke Physical Activity

Abstract

Background: Exercise post-stroke can improve health-related quality of life and promote physical fitness, walking, and balance. Physical activity (PA) is important in post-stroke rehabilitation and recovery through the reduction of cardiovascular risk factors and lowering the risk of recurrent stroke and mortality. Objective: To assess if area PA resources influence the change in PA 12-months post-stroke. Methods: Addresses of 546 mild stroke survivors from the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) study were geocoded to the census tract level and merged with the density of physical activity resources from the National Neighborhood Data Archive (NaNDA). We modeled the odds of perceived change in PA at 12-months post-stroke (more active vs. about the same vs. less active) and number of fitness and recreational sports centers per square mile using multinomial logistic regression. Selection bias due to loss-to-follow-up was accounted for using stablized inverse probability weights with robust standard errors. Models were adjusted for age, gender, race/ethnicity, education, insurance, BMI, and intervention. Results: A total of 333 participants had 12-month PA data with 17.2% reporting being more physically active and 48.0% being about the same at 12 months. The adjusted odds of being more active compared to less active were 1.57 times larger when comparing the 90 th percentile of PA resources to the 10 th percentile (range: 58 resources; 95% CI: 0.99, 2.48). Similarly, adjusted odds of reporting the same level of PA compared to less active were 1.47 times larger when the 90 th and 10 th percentiles of PA resources are compared (95% CI: 0.99, 2.17). Conclusion: Stroke survivors report higher odds of both maintaining the same level of PA and being more physically active when there are more PA resources in the area. This study demonstrates the potentially important role of the physical and built environment on physical fitness post-stroke.