Movement behavior remains stable in stroke survivors within the first two months after returning home

Abstract

Background and purpose: The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients.

Methods: A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories.

Results: In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found.

Conclusion: Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.

Fig 1. Sedentary time in hours per day between three weeks and eight weeks after discharge from the hospital in stroke survivors.

Fig 2. Light physical activity in hours per day between three weeks and eight weeks after discharge from the hospital in stroke survivors.

Fig 3. Moderate to vigorous physical activity in hours per day between three weeks and eight weeks after discharge from the hospital in stroke survivors.

Fig 4. Moderate to vigorous physical activity bouts (≥10 minutes) in hours per day between three weeks and eight weeks after discharge from the hospital in stroke survivors.

Fig 5. Weighted median sedentary bout in minutes per day between three weeks and eight weeks after discharge from the hospital in stroke survivors.