Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
BMJ Open. 2017 Aug 4;7(8):e016369. doi: 10.1136/bmjopen-2017-016369.
To investigate which variables present prior and early after stroke may have an impact on the level of physical activity (PA) 1 year poststroke.
Prospective longitudinal cohort and logistic regression analysis.
Stroke Unit at Sahlgrenska University Hospital, Gothenburg, Sweden.
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.
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.
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).
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.
ClinicalTrials.gov (NCT01115348).
探究哪些变量在中风前和中风后早期出现可能会对中风后 1 年的身体活动(PA)水平产生影响。
前瞻性纵向队列和逻辑回归分析。
瑞典哥德堡萨尔格林斯卡大学医院的中风病房。
连续招募了在 18 个月期间入住中风病房的作为 Stroke Arm Longitudinal Study(SALGOT)一部分的 117 名个体。纳入标准为:首次中风、上肢功能受损、发病后 3 天内入住中风病房、当地居住和年龄≥18 岁。排除标准为:上肢状况或中风前严重多重障碍、预期寿命短和非英语母语者。77 名在中风后 1 年进行随访的参与者被纳入分析。
中风后 1 年的 PA 水平使用 Saltin-Grimby 量表的 6 级进行评估,该量表首先被分为主要不活跃或主要活跃,其次分为低或中/高度 PA。
中风后 1 年主要不活跃的情况可由发病年龄(OR 1.07,95%CI 1.00 至 1.13,p=0.041)、出院时的功能依赖(OR 7.01,95%CI 1.73 至 28.43,p=0.006)和中风前的 PA(OR 7.46,95%CI 1.51 至 36.82,p=0.014)预测。中风后 1 年 PA 水平较低的情况可由发病年龄(OR 1.13,95%CI 1.06 至 1.21,p<0.001)和出院时的功能依赖(OR 3.62,95%CI 1.09 至 12.04,p=0.036)预测。
先前的低 PA 水平、年龄较大和功能依赖都有助于预测中风后 1 年的低 PA。这些结果表明,年龄和中风后早期的简单临床评估可能有助于临床医生识别出中风后活动不足的风险人群。需要进一步研究以明确这些发现是否适用于大量的中风幸存者。
ClinicalTrials.gov(NCT01115348)。