Physiotherapy Department, Alfred Health, Melbourne, Australia.
Physiotherapy Department, La Trobe University, Melbourne, Australia.
Phys Ther. 2021 Feb 4;101(2). doi: 10.1093/ptj/pzaa205.
The purpose of this study was to explore associations between physical activity, cardiovascular risk factors, mobility, mood, fatigue, and cognition over 2 years following stroke rehabilitation discharge.
In this longitudinal observational study, survivors of first-ever stroke were evaluated at rehabilitation discharge and 6, 12, and 24 months later. Moderate to vigorous physical activity (MVPA) duration (minutes/day) assessed with an electronic monitor was the primary outcome. Further outcomes included step count, the number and duration of MVPA and sedentary bouts, cardiovascular risk factors (eg, blood pressure, fasting lipid profile, body mass index [BMI]), gait speed and endurance, mood, fatigue, and cognition. Associations between physical activity and cardiovascular risk factors over time were assessed with random-effects regression modeling. Associations between baseline characteristics and physical activity at 2 years were explored using regression modeling.
Seventy-nine participants (68.4% men) with a mean age of 65 years (SD = 14) and a median gait speed of 1.2 m/s (interquartile range = 0.8 to 1.4) were included at baseline. Associations were found between higher physical activity (MVPA duration, number and duration of MVPA bouts) and lower BMI. Better gait speed, endurance, and cognition at baseline were associated with higher MVPA and step count at 2 years.
Duration and bouts of MVPA are associated with BMI. Increasing MVPA and bouts of MVPA may be a valuable treatment goal to reduce cardiovascular risk in survivors of stroke.
This 2-year study found that MVPA is associated with important cardiovascular risk factors in people who have survived stroke. Understanding these associations could be useful for developing effective treatments to prevent recurrent stroke.
Performing MVPA and accumulating in bouts of at least 10 minutes might be challenging, but it could be an important component of treatments to reduce cardiovascular risk after stroke.
本研究旨在探讨脑卒中康复出院后 2 年内体力活动、心血管危险因素、活动能力、情绪、疲劳和认知之间的关联。
在这项纵向观察性研究中，对首次脑卒中幸存者在康复出院时以及 6、12 和 24 个月后进行评估。使用电子监测器评估的中等到剧烈体力活动（MVPA）时间（分钟/天）是主要结局。其他结局包括步数、MVPA 和久坐时间的次数和持续时间、心血管危险因素（如血压、空腹血脂谱、体重指数[BMI]）、步态速度和耐力、情绪、疲劳和认知。使用随机效应回归模型评估体力活动与随时间变化的心血管危险因素之间的关联。使用回归模型探讨基线特征与 2 年后体力活动之间的关系。
79 名参与者（68.4%为男性），平均年龄 65 岁（SD=14），中位步态速度为 1.2m/s（四分位间距=0.8 至 1.4），基线时纳入研究。发现体力活动较高（MVPA 持续时间、MVPA 次数和持续时间）与 BMI 较低相关。基线时较好的步态速度、耐力和认知与 2 年后的 MVPA 和步数较高相关。
MVPA 持续时间和 MVPA 时间与 BMI 相关。增加 MVPA 和 MVPA 时间可能是降低脑卒中幸存者心血管风险的有价值的治疗目标。
这项为期 2 年的研究发现，MVPA 与脑卒中幸存者的重要心血管危险因素相关。了解这些关联可能有助于开发有效的治疗方法，以预防中风复发。
进行 MVPA 并累计至少 10 分钟的时间可能具有挑战性，但这可能是降低中风后心血管风险的治疗的重要组成部分。
