Factors Associated with Level of Physical Activity After Minor Stroke

Charlotta Hamre,Brynjar Fure,Jorunn Lægdheim Helbostad,Torgeir Bruun Wyller,Hege Ihle-Hansen,Georgios Vlachos,Marie Helene Ursin,Gro Gujord Tangen

doi:10.1016/j.jstrokecerebrovasdis.2021.105628

Abstract

ObjectivesTo explore factors from the acute phase, and after three and 12 months, associated with level of self-reported physical activity 12 months after a minor ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 in persons 70 years or younger. Materials and methodIn this longitudinal cohort study patients were recruited consecutively from two stroke units. Activity level were measured with three sets of questions addressing the average number of frequency (times exercising each week), the average intensity, and duration (the average time), and a sum score was constructed. The association between physical activity 12 months after stroke and sociodemographic factors, NIHSS, body mass index, balance, and neuropsychiatric symptoms were explored using multiple linear regression. ResultsThis study included 101 patients, with mean age (SD) 55.5 (11.4) years, NIHSS median (Q1, Q3) 0.0 (0.0, 1.0), and 20 % were female. Multiple linear regression analyses showed sick leave status at stroke onset, balance at three and 12 months, and anxiety, depression, apathy, and fatigue at 12 months to be factors associated with physical activity at 12 months after stroke. ConclusionWe found that pre-stroke sick leave, post-stroke balance, and neuropsychiatric symptoms were associated with the level of physical activity one year after minor stroke. This might be of importance when giving information about physical activity and deciding about post-stroke follow-up.

Highlights

Health authorities recommend physical activity for general health and to prevent cardiovascular events.[1,2] Despite this, physical inactivity is the fourth leading risk factor for global mortality.[3]
At the three investigated time points À acute phase, three, and 12 months À we found that being on sick leave at stroke onset, balance at three and 12 months, and anxiety, depression, apathy, and fatigue at 12 months were independently associated with level of physical activity at 12 months
In line with the review of Thilarajah et al.,[17] we found that balance both at three and 12 months was associated with physical activity

Summary

Introduction

Health authorities recommend physical activity for general health and to prevent cardiovascular events.[1,2] Despite this, physical inactivity is the fourth leading risk factor for global mortality.[3] Physical activity has been defined as any bodily movement produced by skeletal muscles that results in energy expenditure, consisting of a broad spectre of daily life activities, including exercise, and resulting in physical fitness.[4] There is a dose-response effect of the amount of physical activity on health, where higher volumes, both time and intensity, of activity are associated with additional health benefits.[1] Physical activity is important after stroke, coming back to pre-stroke capacity[5], as well as for secondary prevention by improving stroke risk factors.[6] In general, people post-stroke have a low level of physical activity, in the longterm.[7]

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Discussion

Conclusion