Recommended moderate to vigorous physical activity levels for people in the chronic phase of stroke can be achieved in outpatient physiotherapy: a multicentre observational study

Abstract

ABSTRACT Background Rehabilitation in the chronic phase of stroke should include 20 minutes of moderate to vigorous physical activity (MVPA). However, the level of compliance with MVPA guidelines in outpatient physiotherapy is unknown. Objectives To investigate (1) whether people in the chronic phase of stroke perform the recommended 20 minutes of MVPA during outpatient physiotherapy sessions in France, (2) whether the person’s clinical characteristics influence MVPA time and (3) which interventions contribute to achievement of recommended MVPA time. Methods This was a multicentre, cross-sectional observational study of routine outpatient physiotherapy sessions in France in people in the chronic phase of stroke. The main measures included MVPA time (determined using a heart rate monitor), clinical tests and types of physiotherapy interventions (recorded by external investigator during 2 sessions for each participant). Results 84 people in the chronic phase of stroke and 152 outpatient physiotherapy sessions in 29 outpatient clinics were included (2021–2022). Median (interquartile range) MVPA time was 25 (7–45) minutes across all sessions. Fifty-nine percent of the sessions fulfilled MVPA guidelines. Among clinical tests, only the Mini-Mental Scale Examination was significantly associated with MVPA time. Endurance, balance, and functional lower limb training were associated with the achievement of MVPA guidelines. Conclusion Outpatient physiotherapy sessions have the potential to meet the MVPA guidelines. Further research is needed to understand the variability of compliance with MVPA guidelines and to develop strategies to increase the integration of MVPA into outpatient physiotherapy sessions.