Yamada Ryuichiro, Shimizu Shinobu, Suzuki Yuta, Nakachi Yuki, Takemura Nami, Taira Katsuya, Yamazato Tomoya, Shimabukuro Michiru, Tsunoda Satoshi, Shimose Ryota, Ogura Misao, Higa Jun, Nakanishi Takayuki, Matsunaga Atsuhiko
Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
J Stroke Cerebrovasc Dis. 2022 May;31(5):106398. doi: 10.1016/j.jstrokecerebrovasdis.2022.106398. Epub 2022 Feb 24.
Clarifying the factors related to decreased physical activity in post-stroke patients is essential for effective disease management. This study aimed to examine the factors influencing the amount of daily steps taken by post-stroke patients in a convalescent rehabilitation ward during activities other than rehabilitation (non-rehabilitation steps).
Eighty-nine post-stroke patients (60.8±14.4 years; 55 men) were enrolled. The inclusion criteria were walking independently within the ward and having a walking speed of ≥24 m/min. Data on patient clinical characteristics including age, sex, body mass index, stroke type, hemiparetic side, and time from stroke onset were collected. Stroke impairment and motor and cognitive functional disabilities were assessed using the Stroke Impairment Assessment Set and the Functional Independence Measure, respectively. The non-rehabilitation steps were calculated by subtracting the steps during the rehabilitation activities from the total steps using Fitbit Flex2.
The average number of non-rehabilitation steps was 4,523±2,339 steps/day. The hierarchical multiple regression analysis revealed that sex, motor disability, and the interaction term of stroke impairment with cognitive disability were significantly related to non-rehabilitation steps. Simple slope analysis demonstrated that the stroke impairment slope was steeper at lower levels than at higher levels of cognitive disability for non-rehabilitation steps.
In addition to independent effects of sex and motor disability, this study found that stroke impairment and cognitive disability were interactively related to non-rehabilitation steps in post-stroke patients in a convalescent rehabilitation ward. These findings may provide useful information for managing physical activity in post-stroke patients after hospital discharge.
明确与中风后患者身体活动减少相关的因素对于有效的疾病管理至关重要。本研究旨在探讨在康复期康复病房中,中风后患者在康复以外的活动(非康复步数)中每日步数的影响因素。
纳入89例中风后患者(年龄60.8±14.4岁;男性55例)。纳入标准为在病房内独立行走且步行速度≥24米/分钟。收集患者的临床特征数据,包括年龄、性别、体重指数、中风类型、偏瘫侧以及中风发病后的时间。分别使用中风损伤评估量表和功能独立性测量量表评估中风损伤以及运动和认知功能障碍。使用Fitbit Flex2通过从总步数中减去康复活动期间的步数来计算非康复步数。
非康复步数的平均值为4523±2339步/天。分层多元回归分析显示,性别、运动障碍以及中风损伤与认知障碍的交互项与非康复步数显著相关。简单斜率分析表明,对于非康复步数,中风损伤斜率在认知障碍较低水平时比在较高水平时更陡。
除了性别和运动障碍的独立影响外,本研究发现中风损伤和认知障碍在康复期康复病房的中风后患者中与非康复步数存在交互关系。这些发现可能为出院后中风患者的身体活动管理提供有用信息。