The Longitudinal Course of Physical Activity Behavior Poststroke and Its Variation Across Subgroups: The Norwegian Cognitive Impairment After Stroke Study.

IMPORTANCE

Despite its importance as a modifiable target poststroke, the longitudinal course of physical activity (PA) is not fully understood.

OBJECTIVE

This study aimed to describe the course of poststroke PA behavior from 3 to 36 months and identify subgroups with different PA patterns using multi-trajectory modeling.

DESIGN

A prospective multicenter cohort study design was used.

SETTING

Follow-up at 3, 18, and 36 months poststroke was community-based.

PARTICIPANTS

In total, 277 individuals (age = 70.1 [SD = 10.9]; 116 [41.9%] female) with primarily mild strokes were included. Participants provided at least 2 follow-up periods with accelerometer data each lasting at least 3 consecutive days.

MAIN OUTCOMES AND MEASURES

At each follow-up, daily estimates of upright time, time spent in light physical activity (LPA), time spent in moderate physical activity (MPA), step count, and the number of sit-to-stand transitions were measured.

RESULTS

Average daily upright time declined by -7.4 min (95% CI = -10.09 to 4.64), and average daily step count declined by -132 steps (95% CI = -176 to -88) each year. Four distinct groups of individuals with different characteristics were identified, following a similar developmental course across PA dimensions over time: one-fourth of the participants (25.6%) were characterized by stable low PA estimates and a tendency to decline over time. Two groups, making up 32.4% and 20.8% of the sample, were characterized by intermediate levels of LPA and MPA, with differing levels of sit-to-stand transitions; and 1 group (21.2% of participants) was characterized by stable high PA duration estimates over time.

CONCLUSIONS

The overall course of PA poststroke was characterized by a modest decrease over 3 years. Differing PA trajectory groups characterized by different demographic and clinical features highlight the diverse needs for supporting people living with stroke in becoming more active.

RELEVANCE

Findings may help clinicians identify subgroups of people with stroke who need extended professional follow-up in long-term rehabilitation.