Changes in the physical activity of acute stroke survivors between inpatient and community living with early supported discharge: an observational cohort study

Abstract

Objective: To describe and compare patterns of physical activity among stroke survivors during their hospital stay and community living with early supported discharge.

Design: Observational cohort study of physical activity before and after early supported discharge.

Setting: UK National Health Service stroke units and participants' homes.

Participants: Forty-one stroke survivors with a mean age of 69 (standard deviation 11) years, and a median Modified Rivermead Mobility Index of 33.5 [interquartile range (IQR) 25.8 to 35.3].

Main outcome measures: The primary outcome measures were time spent in sitting/standing/walking and number of steps taken, as recorded by a physical activity monitor.

Results: There were statistical differences (P<0.001) for all categories of physical activity. After early supported discharge to the community, participants took more than twice the number of steps {median 474 (IQR 189 to 773) vs. 1193 (IQR 512 to 2856), median difference 636 [95% confidence interval (CI) 262 to 931]} and spent more than double the time in standing [median 51 (IQR 22 to 128) minutes vs. 100 (IQR 51 to 178) minutes, median difference 28 (95% CI 11 to 68)] compared with their hospital stay.

Conclusion: Community living with early supported discharge promoted higher levels of physical activity in medically stable stroke survivors. The near-doubling of activity may serve as a guideline for what is achievable during stroke rehabilitation.

Clinical trial registration: Number UKCRN 15472.

Keywords: Observational study; Physical fitness; Rehabilitation; Stroke; Walking.