Emily A Kringle1, Bethany Barone Gibbs2,3, Grace Campbell4, Michael McCue5, Lauren Terhorst1, Jessica Kersey1, Elizabeth R Skidmore1. 1. Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA. 2. Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA. 3. Department of Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA. 4. Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA. 5. Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: Evidence suggests that frequent engagement in daily activities requiring physical activity may influence risk factors for recurrent stroke. The effects of nonpharmacological interventions on daily physical activity levels and sedentary behavior are unclear. OBJECTIVE: To describe the effects of interventions on levels of daily physical activity and sedentary behavior among people with stroke. METHODS: OVID/Medline, CINAHL, PsycINFO, and the Cochrane Database were searched using the following search terms: stroke, rehabilitation, intervention, sedentary, physical activity, lifestyle, self-management, and exercise. Data extraction and risk of bias assessment were conducted by two authors. RESULTS: Thirty-one interventions were identified that included exercise, behavior change techniques, and education components. These components were delivered alone and in varying combinations. At postintervention, between-group effects on change scores (Cohen's d = 0.17-0.75, P < .05) or between-group differences in odds of participating in daily physical activity (odds ratio [OR] = 2.07, P < .05) were detected in six studies, and within-group effects in nine studies (Cohen's d = 0.21-3.97, P < .05). At follow-up, between-group differences in odds of participating in daily physical activity were detected in one study (OR = 2.64, P < .05), and within-group effects in two studies (Cohen's d = 0.25, P < .05). No effects (P < .05) were detected in 17 studies. CONCLUSION: It may be possible to modify daily physical activity levels and sedentary behavior poststroke; however, there is insufficient evidence to suggest the superiority of a particular intervention approach. Future studies should explore the unique contributions of individual intervention components to guide development of parsimonious multicomponent interventions that are effective for promoting daily physical activity and reducing sedentary behavior among people with stroke. LEVEL OF EVIDENCE: I.
BACKGROUND: Evidence suggests that frequent engagement in daily activities requiring physical activity may influence risk factors for recurrent stroke. The effects of nonpharmacological interventions on daily physical activity levels and sedentary behavior are unclear. OBJECTIVE: To describe the effects of interventions on levels of daily physical activity and sedentary behavior among people with stroke. METHODS: OVID/Medline, CINAHL, PsycINFO, and the Cochrane Database were searched using the following search terms: stroke, rehabilitation, intervention, sedentary, physical activity, lifestyle, self-management, and exercise. Data extraction and risk of bias assessment were conducted by two authors. RESULTS: Thirty-one interventions were identified that included exercise, behavior change techniques, and education components. These components were delivered alone and in varying combinations. At postintervention, between-group effects on change scores (Cohen's d = 0.17-0.75, P < .05) or between-group differences in odds of participating in daily physical activity (odds ratio [OR] = 2.07, P < .05) were detected in six studies, and within-group effects in nine studies (Cohen's d = 0.21-3.97, P < .05). At follow-up, between-group differences in odds of participating in daily physical activity were detected in one study (OR = 2.64, P < .05), and within-group effects in two studies (Cohen's d = 0.25, P < .05). No effects (P < .05) were detected in 17 studies. CONCLUSION: It may be possible to modify daily physical activity levels and sedentary behavior poststroke; however, there is insufficient evidence to suggest the superiority of a particular intervention approach. Future studies should explore the unique contributions of individual intervention components to guide development of parsimonious multicomponent interventions that are effective for promoting daily physical activity and reducing sedentary behavior among people with stroke. LEVEL OF EVIDENCE: I.
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
Authors: Roderick Wondergem; Martijn F Pisters; Martijn W Heijmans; Eveline J M Wouters; Rob A de Bie; Cindy Veenhof; Johanna M A Visser-Meily Journal: PLoS One Date: 2020-03-26 Impact factor: 3.240