From the Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, Illinois (NPG); and Department of Health Exercise and Sports Sciences, University of New Mexico, Albuquerque, New Mexico (KB).
Am J Phys Med Rehabil. 2020 Aug;99(8):733-738. doi: 10.1097/PHM.0000000000001410.
Impairment caused by stroke is a major cause of disablement in older adults. Physical activity has been shown to improve physical functioning; however, little research has been done to explore how physical activity of different intensities may affect physical function among stroke survivors. The purpose of this study was to examine the patterns of accelerometer-measured physical activity and the relationship between physical activity intensities and objective physical functioning and perceived functional limitations in stroke survivors.
Stroke survivors (N = 30, mean age = 61.77 ± 11.17) completed the Short Physical Performance Battery and the Late-Life Function and Disability Instrument. Physical activity intensities were measured objectively using a 7-day actigraph accelerometer wear period and scored using the National Health and Nutrition Examination Survey cutoffs for sedentary (counts/minute ≤100), light (counts/minute 101-2019), and moderate to vigorous (moderate to vigorous physical activity counts/minute ≥2020) activity.
Multiple linear regressions controlling for age and time since stroke demonstrated that higher levels of moderate to vigorous physical activity predicted better Short Physical Performance Battery performance (β = .43, P = 0.04). For self-reported physical function, light physical activity predicted better basic lower limb function (β = .45, P = 0.009), better advanced lower limb function (β = .53, P = 0.003), better upper limb function (β = .37, P = 0.04), and higher total function score (β = .52, P = 0.002) on the Late-Life Function and Disability Instrument.
These findings suggest that light activity as well as moderate to vigorous physical activity may contribute to better physical functioning in stroke survivors. Although moderate to vigorous physical activity significantly predicted the objective measure of physical function (Short Physical Performance Battery), light physical activity consistently predicted higher scores on all subscales of the Late-Life Function and Disability Instrument. Disabilities resulting from stroke may limit this population from engaging in moderate to vigorous physical activity, and these findings highlight the importance of light physical activity, which may offer similar perceived functional benefits. Future studies should focus on development of effective exercise interventions for stroke survivors by incorporating and comparing both moderate to vigorous physical activity and light-intensity physical activity.
中风导致的身体损伤是老年人身体残疾的主要原因。已有的研究表明，身体活动可以改善身体机能；但是，对于不同强度的身体活动如何影响中风幸存者的身体机能，研究还较少。本研究的目的是探究计步器测量的身体活动模式，以及身体活动强度与中风幸存者的客观身体机能和感知功能限制之间的关系。
30 名中风幸存者（平均年龄=61.77±11.17 岁）完成了简短身体机能测试和晚年生活功能和残疾量表。使用为期 7 天的活动记录仪计步器佩戴期进行客观的身体活动强度测量，并使用国家健康和营养检查调查的静息（计步/分钟≤100）、轻量（计步/分钟 101-2019）和中等到剧烈（中等到剧烈身体活动计步/分钟≥2020）活动的切点进行评分。
在控制年龄和中风后时间的情况下进行多元线性回归分析表明，更高水平的中等到剧烈身体活动与更好的简短身体机能测试表现相关（β=0.43，P=0.04）。对于自我报告的身体功能，轻量身体活动与更好的基本下肢功能（β=0.45，P=0.009）、更好的高级下肢功能（β=0.53，P=0.003）、更好的上肢功能（β=0.37，P=0.04）和更高的总功能评分（β=0.52，P=0.002）相关。
这些发现表明，轻量活动以及中等到剧烈身体活动可能有助于改善中风幸存者的身体机能。虽然中等到剧烈身体活动显著预测了身体功能的客观测量（简短身体机能测试），但轻量身体活动始终预测了晚年生活功能和残疾量表的所有子量表的更高得分。中风导致的残疾可能限制了这一人群进行中等到剧烈身体活动，这些发现强调了轻量身体活动的重要性，它可能提供类似的感知功能益处。未来的研究应通过结合和比较中等到剧烈身体活动和低强度身体活动，重点关注为中风幸存者开发有效的运动干预措施。
