Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, Australia.
Disabil Rehabil. 2020 Mar;42(6):763-769. doi: 10.1080/09638288.2018.1508513. Epub 2019 Feb 6.
: To determine which impairments, activity limitations and personal factors at hospital discharge poststroke predict volume, frequency, and intensity of walking activity 1, 3, and 6 months later. Prospective longitudinal observational study. Thirty-six people with stroke (71 SD 14 years, 69% male) were recruited at hospital discharge and predictors including fatigue, mood, executive function, walking speed, walking endurance, age, prestroke activity, self-efficacy, and perceived stroke recovery and health were collected. At 1, 3, and 6 months follow-up, participants wore an ActivPAL™ accelerometer to collect measures of walking activity.: At 1 month, walking endurance predicted all walking activity ( > 0.29, < 0.01). At 3 months, walking endurance and prestroke activity predicted activity volume and intensity ( = 0.46-0.61, < 0.001), and prestroke activity predicted activity frequency ( = 0.31, = 0.004). At 6 months, age-predicted activity volume and frequency ( = 0.34-0.35, < 0.003), while prestroke activity, discharge walking endurance, and executive function together predicted activity intensity ( = 0.79, < 0.001).: Walking endurance contributes to walking activity outcomes across the first 6 months following hospital discharge poststroke. After 1 month of discharge, factors other than poststroke changes also contribute to activity outcomes, and should be considered when targeting poststroke physical activity.Implications for rehabilitationWalking endurance should be addressed during stroke rehabilitation as higher scores are linked to more walking activity in the first month after discharge.Prestroke factors such as low prestroke activity levels and older age predict reduced walking activity after stroke, so approaches to address barriers these factors may pose are needed in people with stroke.Physical activity interventions should be tailored to the individual, their environment, and context, and take into consideration prestroke factors.
: 目的：确定脑卒中出院时哪些损伤、活动受限和个人因素可预测 1、3 和 6 个月后步行活动的量、频率和强度。前瞻性纵向观察研究。在脑卒中出院时招募了 36 名脑卒中患者（71 ± 14 岁，69%为男性），并收集了疲劳、情绪、执行功能、步行速度、步行耐力、年龄、发病前活动、自我效能和感知脑卒中恢复及健康等预测因素。在 1、3 和 6 个月的随访中，参与者佩戴 ActivPAL™加速度计来收集步行活动的测量值。: 1 个月时，步行耐力可预测所有步行活动（ > 0.29， < 0.01）。3 个月时，步行耐力和发病前活动可预测活动量和强度（ = 0.46-0.61， < 0.001），而发病前活动可预测活动频率（ = 0.31， = 0.004）。6 个月时，年龄预测活动量和频率（ = 0.34-0.35， < 0.003），而发病前活动、出院时步行耐力和执行功能共同预测活动强度（ = 0.79， < 0.001）。: 脑卒中出院后 6 个月内，步行耐力对步行活动结果有影响。出院后 1 个月，除脑卒中后变化外，其他因素也对活动结果有影响，因此在针对脑卒中后体力活动时应考虑这些因素。: 康复意义：脑卒中康复期间应解决步行耐力问题，因为得分越高，出院后第 1 个月的步行活动越多。发病前因素，如低发病前活动水平和年龄较大，预测脑卒中后步行活动减少，因此需要针对这些因素采取措施。: 体力活动干预措施应根据个体、环境和背景进行调整，并考虑发病前因素。
