Fini Natalie A, Holland Anne E, Keating Jenny, Simek Jacinta, Bernhardt Julie
Physiotherapy Department, Caulfield Hospital, Alfred Health, 260 Kooyong Rd, Caulfield, Victoria, 3162 Australia; Department of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia; and Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Department of Physiotherapy, La Trobe University, Melbourne, Victoria, Australia, and Alfred Health, Melbourne, Victoria, Australia.
Phys Ther. 2017 Jul 1;97(7):707-717. doi: 10.1093/ptj/pzx038.
Mobility limitations are common following stroke and frequently lead to poor participation in physical activity (PA).
The purpose of this study was to describe PA across the various stages following stroke (acute, subacute, and chronic).
Searches were conducted in 5 databases.
Eligible studies included participants with stroke whose PA was quantitatively measured for at least 4 hours in a single session. Two reviewers independently reviewed titles and abstracts.
One reviewer extracted data and assessed quality using the Downs and Black checklist. Weighted means were calculated for PA outcomes.
Searches yielded 103 eligible papers including 5306 participants aged 21 to 96 years. Devices (eg, activity monitors) were used in 73 papers, and behavioral mapping (observational monitoring) in 30. Devices show that people with stroke took on average 5535 steps per day (n = 406, 10 studies) in the subacute phase and 4078 steps (n = 1280, 32 studies) in the chronic phase. Average daily walking duration (% measured time) was higher in the chronic phase (9.0%, n = 100) than subacute (1.8%, n = 172), and sedentary time was >78% regardless of time post stroke. Acute data were lacking for these variables. Matched healthy individuals took an average of 8338 steps per day (n = 129). Behavioral mapping showed time in bed was higher in the acute than subacute phase (mean 45.1% versus 23.8%), with similar time spent sitting (mean 37.6% versus 32.6%).
Limitations of this review include not pooling data reported as medians.
Physical activity levels do not meet guidelines following stroke. Time spent inactive and sedentary is high at all times. Increasing PA and developing standardized activity targets may be important across all stages of stroke recovery.
中风后行动受限很常见，且常常导致身体活动（PA）参与度低。
本研究的目的是描述中风后各个阶段（急性期、亚急性期和慢性期）的身体活动情况。
在5个数据库中进行了检索。
符合条件的研究包括中风患者，其身体活动在单次会话中进行了至少4小时的定量测量。两名评审员独立评审标题和摘要。
一名评审员使用唐斯和布莱克清单提取数据并评估质量。计算身体活动结果的加权平均值。
检索得到103篇符合条件的论文，包括5306名年龄在21至96岁之间的参与者。73篇论文使用了设备（如活动监测器），30篇使用了行为映射（观察性监测）。设备显示，中风患者在亚急性期平均每天走5535步（n = 406，10项研究），在慢性期平均每天走4078步（n = 1280，32项研究）。慢性期的平均每日步行时长（测量时间的百分比）高于亚急性期（9.0%，n = 100）（1.8%，n = 172），且无论中风后的时间如何，久坐时间均>78%。这些变量缺乏急性期数据。匹配的健康个体平均每天走8338步（n = 129）。行为映射显示，急性期卧床时间高于亚急性期（平均45.1%对23.8%），坐着的时间相似（平均37.6%对32.6%）。
本综述的局限性包括未汇总报告为中位数的数据。
中风后身体活动水平未达到指南要求。不活动和久坐的时间一直很高。在中风恢复的所有阶段增加身体活动并制定标准化的活动目标可能很重要。
