Effect of Pre-Hospitalization Fall History on Physical Activity and Sedentary Behavior After the Implementation of a Behavioral Change Approach in Patients with Minor Ischemic Stroke: A Secondary Analysis of a Randomized Controlled Trial.

Abstract

We aimed to determine whether a history of falls before admission affected physical activity levels and sedentary behavior negatively after implementing a behavior modification approach in patients with minor ischemic stroke. This study constituted a secondary analysis of an intervention trial. In the intervention study, patients with minor ischemic stroke were randomly assigned to two groups: intervention and control groups. The intervention group was encouraged to reduce sedentary behavior during hospitalization and after discharge, while the control group was encouraged to increase physical activity levels solely during hospitalization. The study included 52 patients who completed the intervention trial. The exposure factor examined was a history of falls. Upon admission, patients were queried about any falls experienced in the year preceding admission and subsequently classified into fall and non-fall groups based on their responses. The primary outcome of interest focused on changes in physical activity levels (step count, light-intensity physical activity, and moderate-to-vigorous-intensity physical activity) and sedentary behavior. Measurements were obtained at two time points: before the intervention, during hospitalization (baseline), and 3months after discharge (post-intervention). Only a significantly lower change in the number of steps taken in the fall group than in the non-fall group was found. Those with a history of falls showed a lesser change in the number of steps taken before and after implementing a behavior change approach compared with those without a history of falls. Those with a history of falls may have engaged in activities other than walking.