Acute Hospital Admission for Stroke Is Characterised by Inactivity

Background. Measuring physical activity behaviours of stroke survivors in the inpatient setting is challenging. Authors of observational studies of early poststroke report that stroke survivors are “inactive and alone”. Using activity monitoring devices may help refine clinical practice and inform therapeutic activity targets. Aim. To measure the physical activity behaviour of stroke survivors during acute inpatient hospitalisation. We hypothesized that greater levels of inactivity would be positively associated with stroke severity and age. Method. Using a cross-sectional study design, consecutive stroke patients admitted to an acute stroke unit (Geelong, Australia) and recruited within 48 hours of admission had their physical activity recorded using an ActivPAL™ accelerometer device over a minimum of 3 days. Activity was categorised as time spent inactive (lying or sitting), standing, or stepping. The number of steps per day was recorded. Demographic and ActivPal™ data are described. Results. Seventy-eight stroke survivors were recruited of whom 54 had complete data for 3 days, all starting within 2 days poststroke. Of the 54 participants, 32 had a mild stroke, 17 moderate, and five severe stroke. Nine were able to walk independently at admission. The median age was 82.5 years (interquartile range (IQR) 74-86), 26 were female. On average, during their inpatient stay, participants spent a median of 98% of their admission inactive. A median of 18 minutes per day was spent standing and less than a minute per day was spent walking amounting to a median of 169 steps taken per day. Conclusion. The ActivePal™ device was feasible to use in an acute stroke setting. We observed high levels of inactivity in the first days post-stroke, highlighting the ongoing challenge of promoting activity in the acute stroke period. To our knowledge, this is the largest study to provide objective data on time spent upright, walking, and sedentary using accelerometer data in an acute stroke setting.

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Prestroke physical activity could influence acute stroke severity (part of PAPSIGOT)

Neurology ◽

10.1212/wnl.0000000000006354 ◽

2018 ◽

Vol 91 (16) ◽

pp. e1461-e1467 ◽

Cited By ~ 15

Author(s):

Malin Reinholdsson ◽

Annie Palstam ◽

Katharina S. Sunnerhagen

Keyword(s):

Physical Activity ◽

Acute Stroke ◽

Odds Ratio ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Activity Level ◽

Stroke Severity ◽

Cross Sectional ◽

Severe Stroke ◽

Younger Age

ObjectiveTo investigate the influence of prestroke physical activity (PA) on acute stroke severity.MethodsData from patients with first stroke were retrieved from registries with a cross-sectional design. The variables were PA, age, sex, smoking, diabetes, hypertension and statin treatment, stroke severity, myocardial infarction, new stroke during hospital stay, and duration of inpatient care at stroke unit. PA was assessed with Saltin-Grimby's 4-level Physical Activity Level Scale, and stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Logistic regression was used to predict stroke severity, and negative binomial regression was used to compare the level of PA and stroke severity.ResultsThe study included 925 patients with a mean age of 73.1 years, and 45.2% were women. Patients who reported light or moderate PA levels were more likely to present a mild stroke (NIHSS score 0 to 5) compared with physically inactive patients in a model that also included younger age as a predictor (odds ratio = 2.02 for PA and odds ratio = 0.97 for age). The explanatory value was limited at 6.8%. Prestroke PA was associated with less severe stroke, and both light PA such as walking at least 4 h/wk and moderate PA 2–3 h/wk appear to be beneficial. Physical inactivity was associated with increased stroke severity.ConclusionsThis study suggests that PA and younger age could result in a less severe stroke. Both light PA such as walking at least 4 h/wk and moderate PA 2–3 h/wk appear to be beneficial.

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Physical activity levels in hospitalised adults with burn injuries

Journal of Burn Care & Research ◽

10.1093/jbcr/irab233 ◽

2021 ◽

Author(s):

Anita Plaza ◽

Julie Adsett ◽

Angela Byrnes ◽

Prue McRae

Keyword(s):

Physical Activity ◽

Total Body Surface Area ◽

Physical Activity Behaviour ◽

Cross Sectional Study ◽

Hospital Length ◽

Burn Injuries ◽

Hospital Length Of Stay ◽

Activity Levels ◽

Cross Sectional ◽

Activity Behaviour

Abstract Physical activity behaviour has not been previously described in hospitalised adults with burn injuries. This prospective, cross-sectional study used a standardised behavioural mapping protocol to observe patient behaviour related to physical activity over a 12-hour period on one weekday in a quaternary referral specialist burn centre. Structured observations were recorded for each of four domains: 1) patient location, 2) position, 3) activity performed and 4) the presence of others. Observations were summarised across all participants as median (IQR) proportion of time. Participants (n=17) were predominantly male (82%) with a mean age of 44.3 (SD 15.2) years, a mean burn size of 34.9% (SD 26.7) total body surface area and a median hospital length of stay of 18 (IQR 6-49) days at time of observation. Participants spent a median of 83% (IQR 73-93) of time in their bedroom, 92% (IQR 68-97) of time in or on their bed and a median of 5% (IQR 3-13) of time mobilising. Exercise accounted for 10% (IQR 8-17) of activity related observations. A median of 68% (IQR 39-83) of time was spent alone. Results suggest time spent engaging in physical activity is low. Further studies are required to investigate motivators and barriers to performing physical activity in this population. This will consequently inform the development and implementation of appropriate strategies to improve physical activity behaviour in this cohort.

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Prevalence and correlates of depression among Nigerian stroke survivors

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v25i0.1252 ◽

2019 ◽

Vol 25 ◽

Cited By ~ 2

Author(s):

Olushola Olibamoyo ◽

Abiodun Adewuya ◽

Bolanle Ola ◽

Olurotimi Coker ◽

Olayinka Atilola

Keyword(s):

Social Support ◽

Cognitive Impairment ◽

Economic Status ◽

Binary Logistic Regression ◽

Clinical History ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Stroke Severity ◽

Stroke Survivors ◽

Cross Sectional

Background: There is mixed evidence for the hypothesis that the risk of depression after stroke is influenced by the location of lesions in the hemispheres, demographic and clinical factors, and disability of stroke survivors.Aim: The current study determined the prevalence of depression and its socio-demographic and clinico-pathological correlates among stroke survivors in a tertiary hospital in Lagos, Nigeria.Method: The cross-sectional study was carried out among 112 adult patients with a clinical history of stroke confirmed by neuroimaging. Depression was diagnosed using Mini International Neuropsychiatric Interview. The socio-demographic profile was obtained, and cognitive impairment was assessed using the Mini-Mental State Examination. Stroke severity was assessed retrospectively using the National Institute of Health Stroke Scale and current disability was measured using the Modified Rankin Scale.Results: There were 48 (42.9%) stroke survivors with a clinical diagnosis of depression. Using binary logistic regression, the independent determinants of depression were younger age, unemployment, perceived poor social support, increasing number of previous admissions because of stroke, cognitive impairment, severity of stroke and current disability status. However, there was no significant association between depression and lesion location.Conclusion: Depression is a common associate of stroke, and there is a need for sustained focus on young stroke survivors with severe stroke, especially those who do not have social support and have low socio-economic status, who may have a higher risk of developing depression following stroke.

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Previous Leisure-Time Physical Activity Dose Dependently Decreases Ischemic Stroke Severity

Stroke Research and Treatment ◽

10.1155/2012/614925 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Dominique Deplanque ◽

Isabelle Masse ◽

Christian Libersa ◽

Didier Leys ◽

Régis Bordet

Keyword(s):

Physical Activity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Exercise Duration ◽

Cross Sectional Study ◽

Lipid Lowering ◽

Favorable Effect ◽

Minor Stroke ◽

Stroke Severity ◽

Cross Sectional

In the present subanalysis of a cross-sectional study showing the favorable effect of prior transient ischemia, leisure-time physical activity, and lipid-lowering drug therapy on stroke severity, we aimed to evaluate whether previous physical activity was dose dependently associated to minor stroke (NIHSS 0–3) and to identify possible underlying factors. Among 362 consecutive patients, less severe stroke was related to weekly exercise duration prior to stroke (no exercise: 36.1%; <2 hours: 49.3%; 2–5 hours: 58.8%; >5 hours: 64.0%; ). Only weak and moderate exercise practices were protective (weak: 50.0%; moderate: 79.3%; heavy: 22.2%; ). Such a beneficial effect was observed independently of age and was associated with a trend to a lower frequency of arterial hypertension, alcohol abuse, and a better metabolic profile. Besides other therapeutic approaches, physical activity may be a simple way to decrease cerebral ischemia severity.

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The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study

BMC Neurology ◽

10.1186/s12883-019-1578-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yared Zenebe Zewde ◽

Abenet Tafesse Mengesha ◽

Yeweynhareg Feleke Gebreyes ◽

Halvor Naess

Keyword(s):

Acute Stroke ◽

Cross Sectional Study ◽

Stroke Severity ◽

Sectional Study ◽

Stroke Management ◽

Stroke Patients ◽

Short Term ◽

Cross Sectional ◽

Specialized Hospital ◽

Tikur Anbessa Specialized Hospital

Abstract Background Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting. Methods A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 h of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as > 140 mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively. Results A total of 103 first-ever acute stroke patients were included (mean age = 55.5 + 15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10–19) compared to normoglycemic patients 11 (IQR 8–15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99–6.19) more likely to be functionally impaired (mRS = 3–5) at 30-days compared to normoglycemic patients (P = 0.041).Older age (≥ 65 years) (P = 0.017) and stroke severity (NIHSS > 14) (P = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association. Conclusions Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-day of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.

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Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2–9-year-old European children?

Public Health Nutrition ◽

10.1017/s136898001400086x ◽

2014 ◽

Vol 18 (5) ◽

pp. 860-868 ◽

Cited By ~ 26

Author(s):

Vera Verbestel ◽

Stefaan De Henauw ◽

Karin Bammann ◽

Gianvincenzo Barba ◽

Charalambos Hadjigeorgiou ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Sedentary Time ◽

Sports Participation ◽

Cross Sectional Study ◽

Future Research ◽

Accelerometer Data ◽

Cross Sectional ◽

Context Specific ◽

Outdoor Playtime

AbstractObjectiveThe aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children.DesignCross-sectional study.SettingSeven European countries taking part in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants) study.SubjectsData were analysed from 2–9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children’s daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ).ResultsSports participation, OPC- and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time.ConclusionsParental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2–9-year-old children’s physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.

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Contexts of sedentary time and physical activity among ageing workers and recent retirees: cross-sectional GPS and accelerometer study

BMJ Open ◽

10.1136/bmjopen-2020-042600 ◽

2021 ◽

Vol 11 (5) ◽

pp. e042600

Author(s):

Sanna Pasanen ◽

Jaana I Halonen ◽

Anna Pulakka ◽

Yan Kestens ◽

Benoit Thierry ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Physical Activity Behaviour ◽

Cross Sectional Study ◽

Active Travel ◽

Secondary Outcome ◽

Cross Sectional ◽

Ageing Workers ◽

Activity Behaviour

ObjectivesWe examined sedentary time and physical activity in different contexts among ageing workers, between their workdays and days off, and recent retirees, between their weekdays and weekend days.DesignCross-sectional study.SettingFinnish Retirement and Aging study and Enhancing physical activity and healthy ageing among recent retirees—Randomised controlled in-home physical activity trial.Participants137 workers (544 measurement days) and 53 retirees (323 days), who provided data for at least 1 workday/weekday and 1 day off/weekend day.Primary and secondary outcome measuresPhysical activity behaviour was measured with a combined Global Positioning System and accelerometer device (SenseDoc V.2.0), providing information on sedentary time, light physical activity and moderate-to-vigorous physical activity (MVPA) by locations (home or non-home) and trips (active travel, ie, speed <20 km/hour and passive travel, ie, speed ≥20 km/hour).ResultsWorkers accumulated more sedentary time and physical activity at non-home locations than at home on workdays, while the opposite was confirmed for days off (p<0.01). Workers accrued more MVPA on days off than on workdays (34 vs 28 min, p<0.05), of which 9 min on workdays and 14 min on days off was accrued during active travel. Retirees’ physical activity behaviour did not differ between weekdays and weekend days (p>0.05). Regardless of the day, retirees accumulated 33 min of daily MVPA, of which 14 min was accrued during active travel.ConclusionsWorkers accumulated more MVPA on days off than on workdays, and their activity behaviour varied between workdays and days off at different locations. Our results showed that a large proportion of the MVPA was accumulated during travel at slower speeds, which suggests that active travel could be a feasible way to increase MVPA among older adults.Trial registration numberNCT03320746.

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Objectively quantified physical activity and sedentary behaviour in a young UAE population

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000957 ◽

2021 ◽

Vol 7 (1) ◽

pp. e000957

Author(s):

Sarah Dalibalta ◽

Amin Majdalawieh ◽

Sarah Yousef ◽

Mohammed Gusbi ◽

Jason J Wilson ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Light Intensity ◽

Sedentary Behaviour ◽

United Arab Emirates ◽

Public Awareness ◽

Adult Population ◽

Cross Sectional Study ◽

Accelerometer Data ◽

Cross Sectional

ObjectivesThere is a lack of public awareness of the importance of engaging in physical activity (PA) in the United Arab Emirates (UAE). Nearly 58% of the UAE adult population self-reports as being physically inactive although little accelerometer data currently exists. The aim of this study was to obtain the first dataset that objectively quantifies PA and sedentary behaviour (SB) in young UAE adults.MethodsThis cross-sectional study recruited 140 university students. Body composition and accelerometry was assessed using a Tanita body composition analyser and ActiGraph accelerometer. Differences (p≤0.05) between gender (male vs female) and body mass index (normal vs overweight/obese) were determined using independent samples t-tests and χ2 tests for nominal variables.ResultsBoth males and females spent high amounts of time in SB, encompassing ~80% of waking hours. PA was primarily light intensity (14.1%), although males spent significantly greater time in moderate-to-vigorous intensity activity. Moreover, 50% of males compared with 76.6% of females were classified as sedentary/low active according to daily step counts.ConclusionOur data provide evidence of high levels of SB among young adults in the UAE with PA being predominantly light intensity, therefore, both PA and SB should be carefully monitored in this country.

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Health-related quality of life profiles and their dimension-specific associated factors among Malaysian stroke survivors: a cross sectional study

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01847-0 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Hui Jie Wong ◽

Pei Lin Lua ◽

Sakinah Harith ◽

Khairul Azmi Ibrahim

Keyword(s):

Physical Activity ◽

Associated Factors ◽

Self Care ◽

Cross Sectional Study ◽

Activity Level ◽

Stroke Survivors ◽

Cross Sectional ◽

Related Quality ◽

Health Related ◽

Anxiety Depression

Abstract Background Apart from maximizing functional abilities and independence after stroke, improving overall health-related quality of life (HRQoL) should also become part of the stroke treatment and rehabilitation process goals. This study aimed to assess the HRQoL profiles and explore the dimension-specific associated factors of HRQoL among stroke survivors. Methods This was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported. Results A total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL. Conclusion Routine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.

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The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia: a cross-sectional study

10.21203/rs.2.13261/v2 ◽

2019 ◽

Author(s):

Yared Zenebe Zewde ◽

Abenet Tafesse Mengesha ◽

Yeweyenhareg Feleke Gebreyes ◽

Halvor Naess

Keyword(s):

Blood Glucose ◽

Acute Stroke ◽

Functional Recovery ◽

Cross Sectional Study ◽

Stroke Severity ◽

Sectional Study ◽

Stroke Management ◽

Stroke Patients ◽

Short Term ◽

Cross Sectional

Abstract Background: Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting.Methods: A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 hours of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as >140mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively.Results: A total of 103 first-ever acute stroke patients were included (mean age = 55.5+15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10-19) compared to normoglycemic patients 11 (IQR 8-15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99-6.19) more likely to be functionally impaired (mRS = 3-5) at 30-days compared to normoglycemic patients (p = 0.041).Older age (≥ 65 years) (p = 0.017) and stroke severity (NIHSS >14) (p = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among the patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association.Conclusions: Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-days of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.

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