How should we measure physical activity after stroke? An international consensus

Natalie A Fini^{1

2}, Dawn Simpson^{2

3

4}, Sarah A Moore^{5

6}, Niruthikha Mahendran^{2

7}, Janice J Eng^{8

9}, Karen Borschmann^{2

10}, David Moulaee Conradsson^{11

12}, Sebastien Chastin¹³, Leonid Churilov^{2

14}, Coralie English^{2

3

4}

Affiliations

¹ Physiotherapy Department, School of Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
² Centre for Research Excellence in Stroke Rehabilitation and Recovery, Florey Institute of Neuroscience, The University of Melbourne, Parkville, VIC, Australia.
³ School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.
⁴ Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
⁵ Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK.
⁶ Stroke Research Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
⁷ Physiotherapy Division, School of health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
⁸ Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada.
⁹ Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
¹⁰ St Vincent's Hospital, Melbourne, VIC, Australia.
¹¹ Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
¹² Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden.
¹³ Institute of Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
¹⁴ Melbourne Medical School, The University of Melbourne, Parkville, VIC, Australia.

PMID: 37300499
PMCID: PMC10614172
DOI: 10.1177/17474930231184108

How should we measure physical activity after stroke? An international consensus

Natalie A Fini et al. Int J Stroke. 2023 Oct.

. 2023 Oct;18(9):1132-1142.

doi: 10.1177/17474930231184108. Epub 2023 Jun 24.

Authors

Affiliations

¹ Physiotherapy Department, School of Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
² Centre for Research Excellence in Stroke Rehabilitation and Recovery, Florey Institute of Neuroscience, The University of Melbourne, Parkville, VIC, Australia.
³ School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.
⁴ Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
⁵ Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK.
⁶ Stroke Research Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
⁷ Physiotherapy Division, School of health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
⁸ Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada.
⁹ Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
¹⁰ St Vincent's Hospital, Melbourne, VIC, Australia.
¹¹ Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
¹² Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden.
¹³ Institute of Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
¹⁴ Melbourne Medical School, The University of Melbourne, Parkville, VIC, Australia.

PMID: 37300499
PMCID: PMC10614172
DOI: 10.1177/17474930231184108

Abstract

Background: Physical activity is important for secondary stroke prevention. Currently, there is inconsistency of outcomes and tools used to measure physical activity following stroke.

Aim: To establish internationally agreed recommendations to enable consistent measurement of post-stroke physical activity.

Methods: Stroke survivors and carers were surveyed online once regarding what is important in physical activity measurement. Three survey rounds with expert stroke researchers and clinicians were conducted using Keeney's Value-Focused Thinking Methodology. Survey 1 identified physical activity tools, outcomes, and measurement considerations which were ranked in Survey 2. Consensus recommendations on tools were then formulated by the consensus group based on survey responses. In Survey 3, participants reviewed ranked results and evidence gathered to determine their support for consensus recommendations.

Results: Twenty-five stroke survivors, 5 carers, 18 researchers, and 17 clinicians from 16 countries participated. Time in moderate-vigorous physical activity and step count were identified as the most important outcomes to measure. Key measurement considerations included the ability to measure across frequency, intensity, duration domains in real-world settings; user-friendliness, comfort, and ability to detect changes. Consensus recommendations included using the Actigraph, Actical, and Activ8 devices for physical activity intensity; ActivPAL for duration and Step Activity Monitor for frequency; and the IPAQ and PASE questionnaires. Survey 3 indicated 100% support for device and 96% for questionnaire recommendations.

Conclusions: These consensus recommendations can guide selection of physical activity measurement tools and outcomes. Tool selection will depend on measurement purpose, user-knowledge, and resources. Comprehensive measurement requires the use of devices and questionnaires.

Keywords: Physical activity; consensus; device; measurement; questionnaire; rehabilitation; stroke.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

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How should we measure physical activity after stroke? An international consensus

Affiliations

How should we measure physical activity after stroke? An international consensus

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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Full Text Sources

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