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      PHYSICAL INACTIVITY AFTER STROKE: INCIDENCE AND EARLY PREDICTORS BASED ON 190 INDIVIDUALS IN A 1-YEAR FOLLOW-UP OF THE FALL STUDY OF GOTHENBURG

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          Abstract

          Objective

          To determine the incidence of physical inactivity and factors prior to stroke and in acute stroke that are associated with physical inactivity 1 year after stroke

          Design

          Prospective longitudinal cohort

          Patients

          A total of 190 consecutively included individuals with acute stroke

          Methods

          A follow-up questionnaire, relating to physical activity level using the Saltin-Grimby Physical Activity Scale, was sent to participants in the Fall Study of Gothenburg 1 year after stroke. Predictors of physical inactivity at baseline were identified using univariable and multivariable logistic regression analyses.

          Results

          Physical inactivity 1 year after stroke was reported by 70 (37%) of the 190 patients who answered the questionnaire and was associated with physical inactivity before the stroke, odds ratio (OR) 4.07 (95% confidence interval (95% CI) 1.69–9.80, p = 0.002); stroke severity (assessed by National Institutes of Health Stroke Scale (NIHSS), score 1–4), OR 2.65 (95% CI) 1.04–6.80, p = 0.042) and fear of falling in acute stroke, OR 2.37 (95% CI 1.01–5.60, p = 0.048).

          Conclusion

          Almost 4 in 10 participants reported physical inactivity 1 year after stroke. Physical inactivity before the stroke, stroke severity and fear of falling in acute stroke are the 3 main factors that predict physical inactivity 1 year after stroke.

          LAY ABSTRACT

          After a stroke, there is a risk of becoming physically inactive, which could affect one’s health. In order to create a rehabilitation plan with individualized preventive actions and interventions against physical inactivity, it is important, early after stroke onset, to identify patients who are at risk of becoming physically inactive. Previous studies of the early prediction of physical inactivity are few in number, with small sample sizes. This research on 190 individuals describes which factors prior to and in acute stroke (which is the first week after stroke) are associated with physical inactivity 1 year after stroke. The results showed that physical inactivity before stroke, stroke severity, and a fear of falling in acute stroke are associated with physical inactivity 1 year after stroke.

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          Most cited references37

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          Receiver operating characteristic curve in diagnostic test assessment.

          The performance of a diagnostic test in the case of a binary predictor can be evaluated using the measures of sensitivity and specificity. However, in many instances, we encounter predictors that are measured on a continuous or ordinal scale. In such cases, it is desirable to assess performance of a diagnostic test over the range of possible cutpoints for the predictor variable. This is achieved by a receiver operating characteristic (ROC) curve that includes all the possible decision thresholds from a diagnostic test result. In this brief report, we discuss the salient features of the ROC curve, as well as discuss and interpret the area under the ROC curve, and its utility in comparing two different tests or predictor variables of interest.
            • Record: found
            • Abstract: found
            • Article: not found

            Health benefits of physical activity: a systematic review of current systematic reviews.

            The health benefits of physical activity and exercise are clear; virtually everyone can benefit from becoming more physically active. Most international guidelines recommend a goal of 150 min/week of moderate-to-vigorous intensity physical activity. Many agencies have translated these recommendations to indicate that this volume of activity is the minimum required for health benefits. However, recent evidence has challenged this threshold-centered messaging as it may not be evidence-based and may create an unnecessary barrier to those who might benefit greatly from simply becoming more active. This systematic review evaluates recent systematic reviews that have examined the relationship between physical activity and health status.
              • Record: found
              • Abstract: found
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              Is Open Access

              A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

              Background Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults. Methods Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted. Results Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores. Conclusion The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report – direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.

                Author and article information

                Journal
                J Rehabil Med
                JRM
                Journal of Rehabilitation Medicine
                Foundation for Rehabilitation Information
                1650-1977
                1651-2081
                14 June 2021
                2021
                : 53
                : 9
                : 2807
                Affiliations
                [1 ]Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Rehabilitation Medicine
                [2 ]Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska, Academy, University of Gothenburg, and Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine
                [3 ]Region Västra Götaland, Sahlgrenska, Department of Rehabilitation Medicine and
                [4 ]Region Västra Götaland, Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
                Author notes
                Correspondence address: Sara Botö, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Fl, SE-413 45 Gothenburg, Sweden E-mail: sara.boto93@ 123456gmail.com
                Article
                JRM-53-9-2807
                10.2340/16501977-2852
                8638731
                34121128
                439bf0b0-3cbf-4c38-9444-3b4b691da9ff
                © 2021 Journal of Rehabilitation Medicine

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 31 May 2021
                Categories
                Original Report

                stroke,physical activity,rehabilitation
                stroke, physical activity, rehabilitation

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