van der Laag Patricia J, Wondergem Roderick, Pisters Martijn F
Physical Therapy Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, the Netherlands.
Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands.
Eur Rev Aging Phys Act. 2022 Apr 22;19(1):11. doi: 10.1186/s11556-022-00290-4.
Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time.
Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals' movement behavior pattern and changes in movement behavior pattern allocation were objectified.
The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers.
The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
中风患者的运动行为（即身体活动水平、久坐行为）并非孤立存在，而是呈现出一定的模式。近期研究确定了中风患者三种常见且不同的运动行为模式。然而，运动行为模式是否保持稳定以及个体的运动行为模式是否会随时间变化仍不明确。
1）研究运动行为模式组成随时间的稳定性；2）确定首次中风患者出院回家后的头两年内，个体的运动行为是否发生变化，从而导致其被分配到另一种运动行为模式。
对RISE队列研究中200名中风患者的加速度计数据进行分析。使用主成分分析压缩10个运动行为变量，并采用K均值聚类法确定出院后三周、六个月、一年和两年时的运动行为模式。研究运动行为模式内各成分的稳定性。对个体运动行为模式的频率及运动行为模式分配的变化进行客观分析。
出院时运动行为模式的组成未随时间改变。基线时，有22%为久坐锻炼者（活跃/久坐），45%为久坐活动者（不活跃/久坐），33%为久坐延长者（不活跃/高度久坐）。35%的中风幸存者在头两年内被分配到另一种运动行为模式，其中63%的人病情恶化为健康风险更高的运动行为模式。两年后，有19%的久坐锻炼者，42%的久坐活动者和39%的久坐延长者。
运动行为模式的组成随时间保持稳定。然而，个体的运动行为会发生变化。被分配到健康风险更高的运动行为模式的人数显著增加。被分配到久坐活动者和久坐延长者的人数增加令人担忧。这凸显了改善或维持健康运动行为以预防中风后未来健康风险的重要性。
