A Kerr1, P Rowe2, D Esson3, M Barber3. 1. Centre of Excellence in Rehabilitation Research, University of Strathclyde, Glasgow, UK. Electronic address: a.kerr@strath.ac.uk. 2. Centre of Excellence in Rehabilitation Research, University of Strathclyde, Glasgow, UK. 3. Lanarkshire Stroke MCN, Monklands Hospital, Airdrie, UK.
Abstract
OBJECTIVE: To describe and compare patterns of physical activity among stroke survivors during their hospital stay and community living with early supported discharge. DESIGN: Observational cohort study of physical activity before and after early supported discharge. SETTING: UK National Health Service stroke units and participants' homes. PARTICIPANTS: Forty-one stroke survivors with a mean age of 69 (standard deviation 11) years, and a median Modified Rivermead Mobility Index of 33.5 [interquartile range (IQR) 25.8 to 35.3]. MAIN OUTCOME MEASURES: The primary outcome measures were time spent in sitting/standing/walking and number of steps taken, as recorded by a physical activity monitor. RESULTS: There were statistical differences (P<0.001) for all categories of physical activity. After early supported discharge to the community, participants took more than twice the number of steps {median 474 (IQR 189 to 773) vs. 1193 (IQR 512 to 2856), median difference 636 [95% confidence interval (CI) 262 to 931]} and spent more than double the time in standing [median 51 (IQR 22 to 128) minutes vs. 100 (IQR 51 to 178) minutes, median difference 28 (95% CI 11 to 68)] compared with their hospital stay. CONCLUSION: Community living with early supported discharge promoted higher levels of physical activity in medically stable stroke survivors. The near-doubling of activity may serve as a guideline for what is achievable during stroke rehabilitation. CLINICAL TRIAL REGISTRATION: Number UKCRN 15472.
OBJECTIVE: To describe and compare patterns of physical activity among stroke survivors during their hospital stay and community living with early supported discharge. DESIGN: Observational cohort study of physical activity before and after early supported discharge. SETTING: UK National Health Service stroke units and participants' homes. PARTICIPANTS: Forty-one stroke survivors with a mean age of 69 (standard deviation 11) years, and a median Modified Rivermead Mobility Index of 33.5 [interquartile range (IQR) 25.8 to 35.3]. MAIN OUTCOME MEASURES: The primary outcome measures were time spent in sitting/standing/walking and number of steps taken, as recorded by a physical activity monitor. RESULTS: There were statistical differences (P<0.001) for all categories of physical activity. After early supported discharge to the community, participants took more than twice the number of steps {median 474 (IQR 189 to 773) vs. 1193 (IQR 512 to 2856), median difference 636 [95% confidence interval (CI) 262 to 931]} and spent more than double the time in standing [median 51 (IQR 22 to 128) minutes vs. 100 (IQR 51 to 178) minutes, median difference 28 (95% CI 11 to 68)] compared with their hospital stay. CONCLUSION: Community living with early supported discharge promoted higher levels of physical activity in medically stable stroke survivors. The near-doubling of activity may serve as a guideline for what is achievable during stroke rehabilitation. CLINICAL TRIAL REGISTRATION: Number UKCRN 15472.
Authors: Lena Rafsten; Anna Danielsson; Asa Nordin; Ann Björkdahl; Asa Lundgren-Nilsson; Maria E H Larsson; Katharina S Sunnerhagen Journal: BMC Neurol Date: 2019-11-09 Impact factor: 2.474
Authors: David H Saunders; Gillian E Mead; Claire Fitzsimons; Paul Kelly; Frederike van Wijck; Olaf Verschuren; Karianne Backx; Coralie English Journal: Cochrane Database Syst Rev Date: 2021-06-29