Abstract

The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found. Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.

Highlights

  • The majority of stroke survivors are discharged to the home setting immediately after hospital care [1]

  • The majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care

  • Movement behavior outcomes remain fairly stable during this period, distinctive subgroup trajectories were found for each movement behavior outcome

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Summary

Introduction

The majority of stroke survivors are discharged to the home setting immediately after hospital care [1]. An important lifestyle intervention that can favorably influence cardiovascular risk is changing movement behaviors [6]. SB is defined as “any waking activity characterized by an energy expenditure of 1.5 metabolic equivalents (METs) and a sitting or reclining posture” [8], LPA consists of activities between 1.5 and 3.0 METs, and MVPA consists of all activities > 3.0 METs. In general, stroke survivors are highly sedentary and inactive compared to healthy peers [9]. The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients

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