Background
Sedentary
time is prevalent following stroke, limiting functional improvement,
and increasing cardiovascular risk. At discharge we examined: 1) change
in sedentary time and activity over the following 3 months’ and 2)
physical, psychological or cognitive factors predicting any change. A
secondary aim examined cross-sectional associations between factors and
activity at 3 months.
Methods
People
with stroke (n = 34) were recruited from two rehabilitation units. An
activity monitor (ActivPAL3) was worn for 7 days during the first week
home and 3 months later. Factors examined included physical,
psychological, and cognitive function. Linear mixed models (adjusted for
waking hours) were used to examine changes in sedentary time, walking,
and step count over time. Interaction terms between time and each factor
were added to the model to determine if they modified change over time.
Linear regression was performed to determine factors cross-sectionally
associated with 3-month activity.
Results
ActivPAL
data were available at both time points for 28 (82%) participants (mean
age 69 [SD 12] years). At 3 months, participants spent 39 fewer minutes
sedentary (95%CI −70,-8 p = .01), 21 minutes more walking (95%CI 2,22 p = .02) and completed 1112 additional steps/day (95%CI 268,1956 p
= .01), compared to the first week home. No factors predicted change in
activity. At 3 months, greater depression (β 22 mins (95%CI 8,36) p
= .004) and slower gait speed (β − 43 mins 95%CI −59,-27 p ≤ 0.001)
were associated with more sedentary time and less walking activity,
respectively.
Conclusions
Sedentary
time reduced and walking activity increased between discharge home and 3
months later. Interventions targeting mood and physical function may
warrant testing to reduce sedentary behavior 3 months following
discharge.(The intervention needed is FOR YOU TO CREATE EXACT PROTOCOLS. This blaming the patient has to stop. YOU ARE TO BLAME FOR THEIR LACK OF RECOVERY.)
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