Prevalence of physical activity and sedentary behavior among stroke survivors in the United States

Abstract

Background: The risk of stroke is greatest among adults who have experienced a previous stroke, transient ischemic attack, or myocardial infarction. Physical activity may reduce the secondary risk of stroke through mediating effects on blood pressure, vasoconstriction, and circulating lipid concentrations; however, little is known about the prevalence of physical activity and sedentary behavior among stroke survivors in the United States.

Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we describe self-reported and objectively measured physical activity and sedentary behavior among adults with a self-reported history of stroke. We also contrast physical activity among stroke survivors with that of adults without stroke (unexposed) to illustrate expected behavior in the absence of disease.

Results: Fewer participants with stroke met weekly physical activity guidelines as outlined in the 2008 Physical Activity Guidelines for Americans when compared with unexposed participants (17.9% vs 25.0%) according to self-reported data. In addition, participants with stroke reported less moderate (46.1% vs 54.7%) and vigorous (9.1% vs 19.6%) leisure activity compared with unexposed participants. As measured by accelerometer, time since diagnosis was inversely associated with physical activity engagement, and participants with stroke recorded more daily hours of sedentary behavior compared with unexposed participants (10.1 hours vs 8.9 hours).

Conclusion: Findings from this study provide a basis for future work seeking to measure the impact of physical activity on the secondary prevention of stroke by characterizing the prevalence of physical activity and sedentary behavior among stroke survivors in the United States.

Keywords: accelerometer; physical activity; physical activity guidelines; sedentary behavior; stroke.

Figure 1

Daily minutes of accelerometer-determined physical activity stratified by time since first stroke event, NHANES 2003–2006. Data were obtained from the NHANES 2003–2006 physical activity monitor examination. Study participants were ambulatory, wore accelerometers at least 3 days for 10 hours per day over the 7-day study period; were ≥ 20 years old; and reported age at first stroke event (n = 256). Moderate to vigorous, low-moderate, and light intensity thresholds were used according to methods by Troiano et al and Matthews et al.^, We report mean physical activity minutes per day and standard errors, controlling for age and wear time.