Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.
Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, University Utrecht, the Netherlands.
Int J Stroke. 2022 Jan;17(1):83-92. doi: 10.1177/17474930211006293. Epub 2021 Apr 7.
Deterioration of physical functioning after stroke in the long term is regarded as a major problem. Currently, the relationship between "peoples'" movement behavior patterns (the composition of sedentary behavior and physical activity during waking hours) directly after stroke and the development of physical functioning over time is unknown. Therefore, the objectives of this study were to investigate (1) the course of physical functioning within the first two years after returning home after stroke, and (2) the association between physical functioning and baseline movement behavior patterns.
In the longitudinal RISE cohort study, 200 persons with a first-ever stroke discharged to the home-setting were included. Participants' physical functioning was assessed within three weeks, at six months, and one and two years after discharge using the Stroke Impact Scale (SIS) 3.0 subscale physical and the five-meter walk test (5MWT). Three distinct movement behavior patterns were identified in a previous study at baseline and were used in the current study: (1) (sufficiently active and 64% of waking hours sedentary) (2) (inactive and 63% of waking hours sedentary) and (3) (inactive and >78% of waking hours sedentary accumulated in long prolonged bouts) The association between movement behavior patterns and the course of physical functioning was determined using longitudinal generalized estimating equations analyses.
Overall participants' physical functioning increased between discharge and six months and declined from six months up to two years. Physical functioning remained stable during the first two years after stroke in . Physical functioning improved during the first six months after discharge in and and deteriorated in the following six months. Only physical functioning (SIS) of further declined from one up to two years. A similar pattern was observed in the 5MWT.
Movement behavior patterns identified directly after returning home in people with stroke are associated with and are predictive of the course of physical functioning. Highly sedentary and inactive people with stroke have unfavorable outcomes over time than individuals with higher amounts of physical activity.
长期以来，中风后身体功能的恶化被认为是一个主要问题。目前，中风后直接返回家庭的人群的“日常”运动行为模式（久坐行为和清醒时体力活动的组成）与随时间推移身体功能的发展之间的关系尚不清楚。因此，本研究的目的是调查：（1）中风后返回家庭的头两年内身体功能的变化过程；（2）身体功能与基线运动行为模式之间的关系。
在 RISE 纵向队列研究中，纳入了 200 名首次中风出院回家的患者。使用中风影响量表（SIS）3.0 身体子量表和 5 米步行测试（5MWT），在出院后 3 周、6 个月、1 年和 2 年评估参与者的身体功能。在基线时的先前研究中确定了三种不同的运动行为模式，并在本研究中使用：（1） （足够活跃，清醒时 64%的时间为久坐）；（2） （不活跃，清醒时 63%的时间为久坐）；（3） （不活跃，清醒时 78%以上的时间积累在长时间的长时间久坐中）。使用纵向广义估计方程分析来确定运动行为模式与身体功能变化之间的关系。
总体而言，参与者的身体功能在出院到 6 个月之间增加，然后从 6 个月到 2 年下降。在 中，中风后前两年身体功能保持稳定。在 和 中，出院后前 6 个月身体功能得到改善，随后 6 个月身体功能恶化。只有 的身体功能（SIS）从 1 年到 2 年持续下降。5MWT 也观察到了类似的模式。
中风后直接返回家庭的人群的运动行为模式与身体功能的变化过程相关，并可预测身体功能的变化过程。与高体力活动的个体相比，长时间久坐和不活跃的中风患者随着时间的推移会出现不良结果。
