scholarly journals Changes in stroke rehabilitation during the SARS-CoV-2 shutdown in Switzerland

2021 ◽  
Author(s):  
Jeremia P. O. Held ◽  
Anne Schwarz ◽  
Johannes Pohl ◽  
Eva Thürlimann ◽  
Silvan Porrtmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Community Dwelling ◽  
Outpatient Rehabilitation ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Neurological Functioning ◽  
Observational Cohort ◽  
The Impact

Introduction: Many stroke survivors require continuous outpatient rehabilitation therapy to maintain or improve their neurological functioning, independence, and quality of life. In Switzerland and many other countries, the shutdown to contain SARS-CoV-2 infections led to mobility restrictions and a decrease in therapy delivery. This study investigated the impact of the COVID-19 shutdown on stroke survivors’ access to therapy, physical activity, functioning and mood. Methods: A prospective observational cohort study in stroke subjects. At 4 time-points (before, during, after the shutdown, and at 3-month follow-up), the amount of therapy, physical activities, motor function, anxiety, and depression were assessed. Results: Thirty-six community-dwelling stroke subjects (median 70 years of age, 10 months post-stroke) were enrolled. Therapy reductions related to the shutdown were reported in 72% of subjects. This decrease was associated with significantly extended sedentary time and minimal deterioration in physical activity during the shutdown. Both parameters improved between reopening and 3-month follow-up. Depressive symptoms increased slightly during the observation period. Patients more frequently reported on self-directed training during shutdown. Conclusion: The COVID-19 shutdown had measurable immediate, but no persistent, effects on post-stroke outcomes, except for depression. Importantly, a 2-month reduction in therapy may trigger improvements when therapy is fully re-initiated thereafter.

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

Personal and social factors that influence physical activity levels in community-dwelling stroke survivors: A systematic review of qualitative literature

2021 ◽  
pp. 026921552199369
Author(s):  
Karl R Espernberger ◽  
Natalie A Fini ◽  
Casey L Peiris
Keyword(s):  
Physical Activity ◽  
Social Factors ◽  
Self Efficacy ◽  
Data Extraction ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Activity Levels ◽  
Post Stroke ◽  
Physical Activity Levels ◽  
Mobile Community

Objectives: To determine the personal and social factors perceived to influence physical activity levels in stroke survivors. Data sources: Four electronic databases (MEDLINE, CINAHL, PubMed and Embase) were searched from inception to November 2020, including reference and citation list searches. Study selection: The initial search yielded 1499 papers, with 14 included in the review. Included articles were peer-reviewed, qualitative studies, reporting on the perceived factors influencing physical activity levels of independently mobile community-dwelling adults, greater than 3 months post stroke. Data extraction: Data extracted included location, study aim, design, participant and recruitment information and how data were collected and analysed. Data synthesis: Thematic analysis was undertaken to identify meanings and patterns, generate codes and develop themes. Five main themes were identified: (i) Social networks are important influencers of physical activity; (ii) Participation in meaningful activities rather than ‘exercise’ is important; (iii) Self-efficacy promotes physical activity and physical activity enhances self-efficacy; (iv) Pre-stroke identity related to physical activity influences post-stroke physical activity; and (v) Formal programmes are important for those with low self-efficacy or a sedentary pre-stroke identity. Conclusions: Physical activity levels in stroke survivors are influenced by social activities and support, pre-stroke identity, self-efficacy levels and completion of activities that are meaningful to stroke survivors.

scholarly journals Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Regression Models ◽  
Community Dwelling ◽  
The Body ◽  
Study Results ◽  
The Impact ◽  
Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

Impact of physical activity, protein intake and social network and their combination on the development of frailty

2019 ◽  
Vol 30 (2) ◽  
pp. 340-346
Author(s):  
Sandra Haider ◽  
Igor Grabovac ◽  
Deborah Drgac ◽  
Christine Mogg ◽  
Moritz Oberndorfer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Social Network ◽  
Protein Intake ◽  
Community Dwelling ◽  
Adverse Health Outcomes ◽  
Low Protein ◽  
Geriatric Condition ◽  
The Impact

Abstract Background Frailty is a geriatric condition associated with adverse health outcomes. As physical inactivity, low protein intake and poor social network are known risk factors, we aimed to assess the influence of these parameters and their interaction in an 11-year follow-up study on a Europe-wide level. Methods Data from the Study on Health, Ageing and Retirement in Europe were used, including 22 226 community-dwelling robust and prefrail persons aged ≥50 years, from 11 countries. Frailty was assessed with the ‘Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe’. Additionally, self-reported physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using multivariate cox regressions. Results Performing no regular PA, was associated with higher hazards ratio (HRs) for frailty compared with performing regular PA [men: 1.90 (95%CI: 1.50–2.42); women: 1.65 (95%CI: 1.25–2.18)]; HRs for low protein intake were 1.16 (95%CI: 0.93–1.46) for men and 1.05 (95%CI: 0.80–1.37) for women. And HR for poor social network were 0.92 (95%CI: 0.74–1.15) for men and 1.72 (95%CI: 1.31–2.27)] for women. In general, persons with a combination of two of the assessed risk factors had a higher risk for frailty compared with those with no or only one of the risk factors. However, no significant synergy index could be found. Conclusion The results illustrate the importance of PA, but also of nutritional and social network to prevent frailty.

Abstract P428: Effects of Tai Chi on Physical Function and Quality of Life in Chronic Stroke

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ruth E Taylor-Piliae ◽  
Tiffany M Hoke ◽  
Joseph T Hepworth ◽  
L. Daniel Latt ◽  
Bijan Najafi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Function ◽  
Tai Chi ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Sf 36 ◽  
Fall Rates

Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 years, time post-stroke=3 years, ischemic stroke=66%, hemiparesis=73%) enrolled. During the intervention, TC participants had 2/3 fewer falls (n=5 falls), than the SS (n=14 falls) and UC (n=15 falls) groups (χ2=5.60, p=0.06). All groups had improvements in the SPPB score (F 1,142 =85.29, p<0.01), after the 12-week intervention. Post-hoc tests following a significant interaction for the 2-Minute StepTest (F 2,142 =4.69, p<0.01) indicated TC (t 53 =2.45, p=0.02) and SS (t 44 =4.63, p<0.01) groups had significantly better aerobic endurance over time, though the UC group did not (t 48 =1.58, p=0.12). All groups reported better perceived physical (SF-36 PCS, F 1,142 =4.15, p=0.04) and mental health (SF-36 MCS, F 1,142 =15.60, p<0.01), after the intervention. There were no significant within group changes in perceived physical health (p>0.05), while significant improvements in perceived mental health (p < 0.05) were observed within all groups. No significant changes in depressive symptoms or sleep quality were observed (p>0.05). Attrition was 10% (n=14), and intervention adherence rates were 85%. Conclusions: Goals of stroke rehabilitation are to prevent disability, improve physical function and quality of life. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention may be more effective in reducing fall rates than SS or UC. Future studies examining the effectiveness of TC to reduce fall rates; and improve physical function and quality of life for community-dwelling stroke survivors are recommended.

Preschoolers’ health-related quality of life following the implementation of a childcare physical activity intervention

2018 ◽  
Vol 43 (5) ◽  
pp. 453-459 ◽  
Author(s):  
Stephanie Truelove ◽  
Andrew M. Johnson ◽  
Leigh M. Vanderloo ◽  
Molly Driediger ◽  
Shauna M. Burke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Controlled Trial ◽  
Health Related Quality ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Being active offers many physical and emotional benefits contributing to a higher health-related quality of life (HRQoL); however, this relationship remains unexplored among preschoolers (aged 2.5–5 years). This study examined the impact of the Supporting Physical Activity in the Childcare Environment (SPACE), which was an intervention implemented using a cluster randomized controlled trial on preschoolers’ HRQoL. Childcare centres were randomly allocated to the experimental (n = 11) or control (n = 11) conditions, and preschoolers’ HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 (3 subscales: physical, psychosocial, and total HRQoL) at baseline, post-intervention (i.e., week 8), and 6- and 12-month follow-up. A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition. Preschoolers (n = 234) with HRQoL data at baseline and one additional time-point were retained for analyses. Body mass index was not found to impact significantly on the intervention, and no statistically significant interaction effects were found for any of the 3 HRQoL variables. In conclusion, the SPACE intervention had no impact on preschoolers’ HRQoL. Given the scarcity of research in this population, additional exploration is necessary to better understand the potential impact of physical activity participation on preschoolers’ HRQoL.

Benefits of a Physical Activity Intervention for Men with Prostate Cancer

2007 ◽  
Vol 29 (1) ◽  
pp. 118-127 ◽  
Author(s):  
S. Nicole Culos-Reed ◽  
John L. Robinson ◽  
Harold Lau ◽  
Kathleen O’Connor ◽  
Melanie R. Keats
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Physical Activity Intervention ◽  
Resting Heart Rate ◽  
Prostate Cancer Survivors ◽  
Home Based ◽  
Fatigue Severity ◽  
The Impact

The purpose of the current study was to examine the viability of conducting a theory-based physical activity (PA) intervention on men with prostate cancer, and the impact of PA on quality of life (QOL). Participants were 31 men, average age of 67 years, with localized or metastatic prostate cancer undergoing androgen deprivation therapy (ADT). Global QOL, fatigue, and PA measures were conducted at baseline and following the 12-week intervention. An additional follow-up testing was conducted 4 months following the intervention (n = 18). Both moderate and strenuous bouts of exercise, as well as functional capacity, increased significantly from pre- to posttest. Both fatigue severity and resting heart rate decreased significantly at posttest. A trend toward improved global QOL was also noted. It was concluded that a 12-week home-based PA intervention may provide health and QOL benefits for prostate cancer patients undergoing ADT. Practitioners are encouraged to promote PA for prostate cancer survivors.

scholarly journals Return to work after stroke – Feasibility of 6-year follow-up

2018 ◽  
Vol 82 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Julie Phillips ◽  
Kathryn Gaffney ◽  
Margaret Phillips ◽  
Kate Radford
Keyword(s):  
Quality Of Life ◽  
Functional Ability ◽  
Feasibility Trial ◽  
Stroke Survivors ◽  
Full Time ◽  
Voluntary Work ◽  
Post Stroke

Introduction Little is known about long-term work sustainability of stroke survivors. A feasibility trial of early stroke specialist vocational rehabilitation had 32/46 (69.5%) participants available for follow-up at 12 months post stroke. Of these, 19/32 (59.4%) were in work. This study aims to determine the feasibility of longer-term follow-up and explore work status 6 years post stroke. Method Forty-eight participants fitting criteria for the feasibility trial were sent postal questionnaires measuring employment, income, mood, functional ability and quality of life, and were invited for interview to explore working 6 years after stroke. Ethical approval was obtained. Results Of the 48 participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24–78) years. Fourteen (74%) reported working (paid work n = 10, voluntary work n = 3, full-time education n = 1). Five had retired. Most (11/13) remained with preinjury employers. Half (8/15, 53%) reported decreased income since stroke. Compared to one year, median functional ability was marginally higher (extended activities of daily living 63 (IQR 8, range 32–66) to 60 (IQR 9, range 17–66)), but health-related quality of life was lower (EuroQuol Visual Analogue Scale mean 77.4 [SD 11] to 70.7 [SD14]). Six interviewees felt returning to work was the correct decision but struggled with invisible impairments. Conclusion This study suggests that long-term follow-up is feasible and that those who made a good recovery were more likely to respond. Work remains important to stroke survivors 6 years post stroke.

Abstract 279: Outcomes From Integrating Stroke Survivors Into Cardiac Rehabilitation

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Elizabeth W Regan ◽  
Reed Handlery ◽  
Sara Wilcox ◽  
Jill Stewart ◽  
Joseph L Pearson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Outcome Expectation ◽  
Stroke Survivors ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Increased Risk ◽  
The Impact ◽  
Minute Walk

Purpose: Lack of physical activity after stroke results in increased risk of stroke recurrence and other health problems. While some survivors receive physical therapy (PT), it is often discontinued within a year. Cardiac Rehabilitation (CR) is a community exercise program for people with cardiac dysfunction; however, stroke is not a covered diagnosis despite high cardiovascular risk. CR for stroke survivors is an opportunity to bridge the gap between PT and community physical activity. The study evaluated the impact of CR participation on stroke survivors. Materials and Methods: A pilot study was completed at a phase 3 CR facility. Participants were screened for eligibility and entered the CR program (3 x per week for 12 weeks) with an aerobic fitness focus. Individual outcomes were taken pre- and post-program, and 6-months follow up. Program impact was measured by paired t-tests (24 participants) and repeated measures ANOVA (18 participants) for 6-month follow up. Results: Twenty-four participants completed the study. Participants were 79% (19/24) male with an average age of 62.2 years old (range 33.5 -81.5) with a time since stroke of 29.7 months (range 3-123). Most participants (20/24) were community ambulators at the start of the study (six-minute walk test (6MWT) > 288 m). Pre-Post Program: The six-minute walk test (6MWT) (endurance) improved by 62 ± 66 m (p<0.005). The five times sit to stand test (5xSS) (strength) improved by 3.8 ± 5.8 sec (P=0.004). The Stroke Impact Scale Mobility Subscale improved by 7.3% ± 11.8%, (p=0.006), the Activities of Daily Living Subscale improved by 6.2% ± 9.9%, (p=0.006) and the Memory Subscale by 6.4% ± 14.7%, (p=0.043). Fast Walking Speed, Self-Efficacy and Exercise Outcome Expectation Scales improved with statistical significance but lacked clinical significance. No other outcomes had statistically significant changes. Six-month Follow up: At 6-month follow up, 89.5% (16/18) of participants were still exercising at least once a week. The CR program elicited statistically significant participant improvements over time in the 6MWT (p=0.001) and 5xSS (p<0.001). Post-hoc analysis revealed a statistically significant improvement from pre-program to 6-month follow up in 6MWT distance (66.52 ± 53.73m, p=0.013), 5xSS (-3.44 ± 2.20s, p=0.003) but not post-program to 6 months follow up 6MWT (-5.2 ± 26.4m, p=1.00) and 5xSS (-0.24 ± 1.69s, p=1.00) demonstrating maintenance of gains, but no additional gains. Conclusions: CR elicited meaningful improvements for stroke survivors (exceeding minimal clinically important differences) in walking endurance, strength, perceived memory and perceived mobility with gains maintained for endurance and strength at 6-month follow up. CR enhances exercise habits and physical activity through structured exercise after discharge from PT and may improve community participation.

scholarly journals Influence of Physical Activity, Protein Intake and Social Network on the Frailty development

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Haider ◽  
T E Dorner ◽  
I Grabovac
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Social Network ◽  
Protein Intake ◽  
Community Dwelling ◽  
Synergy Index ◽  
Follow Up Study ◽  
Low Protein ◽  
The Impact

Abstract Background Frailty, a geriatric syndrome, is associated with many adverse health outcomes. Risk factors include physical inactivity, low protein intake and an inadequate social network. In this analysis we aimed to assess the influence of these factors and their combination in an 11-year-follow-up study on a Europe-wide level. Methods The analysed dataset included 22,226 community-dwelling robust and prefrail persons aged ≥50 years (11 countries) from the Study on Health, Ageing and Retirement in Europe (SHARE). Frailty was measured with the “Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe”. Additionally, self-reported level of vigorous physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using Cox regressions, adjusted for age, education, smoking, alcohol BMI, depression, long-term illness and each other. Results People who do not engage in PA, had a higher HRs for frailty development compared to people performing PA regularly [women: 1.62 (95%CI: 1.22-2.13); men: 1.83 (95%CI: 1.44-2.33)]. People with low protein intake did not have significant higher HR [women: 1.05 (95%CI: 0.80-1.37); men: 1.16 (95%CI: 0.93-1.46)]. Women with poor social network showed HRs of 1.34 (95%CI: 1.24-2.15)], men with poor social network had a HR of 0.88 (95%CI: 0.70-1.10). In general, we found that persons with a combination of two risk factors had a higher risk for frailty compared to those with no or only one. However, no significant synergy index could be found. Conclusions Regular PA, but also adequate social networks seem to be important factors in frailty prevention. Key messages Sufficient PA and satisfaction with social network were shown as modifiable factors to prevent frailty in an 11-year-follow-up study. A combination of two risk factors was associated with a higher risk for frailty compared to one, however, with no significant synergy index.

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