Luzum Geske, Allore Heather, Han Ling, Saltvedt Ingvild, Tan Xiangchun, Thingstad Pernille, Håberg Asta, Askim Torunn
Norwegian University of Science and Technology, Department of Neuromedicine and Movement Science, 7491 Trondheim, Norway.
School of Medicine, Yale University, New Haven, CT 06510, United States.
Phys Ther. 2025 Jul 1;105(7). doi: 10.1093/ptj/pzaf069.
Despite its importance as a modifiable target poststroke, the longitudinal course of physical activity (PA) is not fully understood.
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.
A prospective multicenter cohort study design was used.
Follow-up at 3, 18, and 36 months poststroke was community-based.
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.
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.
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.
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.
Findings may help clinicians identify subgroups of people with stroke who need extended professional follow-up in long-term rehabilitation.
尽管身体活动（PA）作为卒中后一个可改变的目标很重要，但其纵向变化过程尚未完全明确。
本研究旨在描述卒中后3至36个月期间PA行为的变化过程，并使用多轨迹模型识别具有不同PA模式的亚组。
采用前瞻性多中心队列研究设计。
卒中后3、18和36个月的随访以社区为基础。
总共纳入了277名主要为轻度卒中的个体（年龄=70.1[标准差=10.9]；116名[41.9%]为女性）。参与者至少提供了2个随访期的加速度计数据，每个随访期至少连续3天。
在每次随访时，测量每日直立时间、轻度身体活动（LPA）时间、中度身体活动（MPA）时间、步数以及坐立转换次数的估计值。
平均每日直立时间每年下降-7.4分钟（95%CI=-10.09至-4.64），平均每日步数每年下降-132步（95%CI=-176至-88）。识别出了四组具有不同特征的个体，随着时间推移，在PA各维度上遵循相似的发展过程：四分之一的参与者（25.6%）的特征是PA估计值稳定较低且有随时间下降的趋势。两组分别占样本的32.4%和20.8%，其特征是LPA和MPA处于中等水平，坐立转换水平不同；还有一组（占参与者的21.2%）的特征是随着时间推移PA持续时间估计值稳定较高。
卒中后PA的总体变化过程的特征是在3年内适度下降。具有不同人口统计学和临床特征的不同PA轨迹组凸显了在支持卒中患者增加活动量方面的多样化需求。相关性：研究结果可能有助于临床医生识别在长期康复中需要延长专业随访的卒中患者亚组。
