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Early prediction of physical activity level 1 year after stroke: A longitudinal cohort study

Journal article
Authors Ola A. Olsson
Hanna C Persson
Margit Alt Murphy
Katharina S Sunnerhagen
Published in Bmj Open
Volume 7
Issue 8
ISSN 2044-6055
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Language en
Links bmjopen.bmj.com/content/7/8/e016369...
doi.org/10.1136/bmjopen-2017-016369
Keywords motor activity, outcome assessment, physical activity, prognosis, stroke, adult, clinical evaluation, cohort analysis, female, human, life expectancy, longitudinal study, major clinical study, male, prediction, speech, stroke unit, survivor, upper limb, young adult
Subject categories Neurology

Abstract

Objective To investigate which variables present prior and early after stroke may have an impact on the level of physical activity (PA) 1 year poststroke. Design Prospective longitudinal cohort and logistic regression analysis. Setting Stroke Unit at Sahlgrenska University Hospital, Gothenburg, Sweden. Participants 117 individuals as part of the Stroke Arm Longitudinal Study (SALGOT) admitted to the stroke unit during a period of 18 months were consecutively recruited. The inclusion criteria were: First-time stroke, impaired upper extremity function, admitted to the stroke unit within 3 days since onset, local residency and ≥18 years old. The exclusion criteria were: Upper extremity condition or severe multi-impairment prior to stroke, short life expectancy and non-Swedish speaking. 77 participants followed up at 1 year poststroke were included in the analysis. Primary outcome PA level 1 year after stroke was assessed using a 6-level Saltin-Grimby Scale, which was first dichotomised into mostly inactive or mostly active and second into low or moderate/high level of PA. Results Being mostly inactive 1 year after stroke could be predicted by age at stroke onset (OR 1.07, 95% CI 1.00 to 1.13, p=0.041), functional dependency at discharge (OR 7.01, 95% CI 1.73 to 28.43, p=0.006) and prestroke PA (OR 7.46, 95% CI 1.51 to 36.82, p=0.014). Having a low level of PA 1 year after stroke could be predicted by age at stroke onset (OR 1.13, 95% CI 1.06 to 1.21, p<0.001) and functional dependency at discharge (OR 3.62, 95% CI 1.09 to 12.04, p=0.036). Conclusions Previous low level of PA, older age and functional dependency all provided value in predicting low PA 1 year after stroke. These results indicate that age and simple clinical evaluations early after stroke may be useful to help clinicians identify persons at risk of being insufficiently active after stroke. Further research is needed to clarify if these findings may apply to the large population of stroke survivors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.

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