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Rehman S, Barker S, Jose K, Callisaya M, Castley H, Schultz MG, Moore MN, Simpson DB, Peterson GM, Gall S. Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation. Healthcare (Basel) 2024; 12:776. [PMID: 38610198 PMCID: PMC11012137 DOI: 10.3390/healthcare12070776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Structured health system-based programs, such as cardiac rehabilitation, may reduce the risk of recurrent stroke. This study aimed to co-design and evaluate a structured program of rehabilitation, developed based on insights from focus groups involving stroke survivors and health professionals. Conducted in Tasmania, Australia in 2019, the 7-week program comprised one hour of group exercise and one hour of education each week. Functional capacity (6 min walk test), fatigue, symptoms of depression (Patient Health Questionnaire), and lifestyle were assessed pre- and post-program, with a historical control group for comparison. Propensity score matching determined the average treatment effect (ATE) of the program. Key themes from the co-design focus groups included the need for coordinated care, improved psychosocial management, and including carers and peers in programs. Of the 23 people approached, 10 participants (70% men, mean age 67.4 ± 8.6 years) completed the program without adverse events. ATE analysis revealed improvements in functional capacity (139 m, 95% CI 44, 234) and fatigue (-5 units, 95% CI -9, -1), with a small improvement in symptoms of depression (-0.8 units, 95% CI -1.8, 0.2) compared to controls. The co-designed program demonstrated feasibility, acceptability, and positive outcomes, suggesting its potential to support stroke survivors.
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Affiliation(s)
- Sabah Rehman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
| | - Seamus Barker
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
| | - Kim Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
- Peninsula Clinical School, Monash University, Frankston, VIC 3199, Australia
| | - Helen Castley
- Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS 7000, Australia;
| | - Martin G. Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
| | - Myles N. Moore
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
| | - Dawn B. Simpson
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (S.R.); (S.B.); (K.J.); (M.C.); (M.N.M.)
- Faculty of Medicine, Dentistry and Health Sciences, Monash University, Melbourne, VIC 3800, Australia
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Espernberger K, Fini NA, Peiris CL. Identity, social engagement and community participation impact physical activity levels of stroke survivors: A mixed-methods study. Clin Rehabil 2022; 37:836-850. [PMID: 36448093 DOI: 10.1177/02692155221141977] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Objective To explore how personal characteristics and social engagement impact the physical activity levels of chronic stroke survivors. Design A mixed-methods study comprising in-depth semi-structured interviews and objective 24-h physical activity monitoring. Interviews were thematically analysed, and activity diaries were compared to activity monitor data to attain a complete picture of physical activity. Triangulation explored the relationship between perceptions, beliefs, activity levels and social engagement. Setting Community. Participants Community-dwelling, independently mobile, adult stroke survivors (n = 19). The mean age was 74 (11 SD) years, 52% female, mean time post-stroke 41 (SD 61) months. Main measures Qualitative and quantitative measures including individual semi-structured interviews, accelerometry, activity diaries, self-efficacy, Frenchay Activities Index and Barthel Index. Results Individual identity had the greatest perceived influence on post-stroke physical activity. Pre-stroke identity, meaningful activities and family culture contributed to identity; while social and community activities, self-efficacy, co-morbidities, stroke symptoms and exercise, also impacted physical activity. Participants averaged 5365 (IQR 3378–7854) steps per day and reported a mean self-efficacy for exercise score of 51 (SD 20). Triangulation showed convergent relationships between post-stroke physical activity levels and participant motivation, comorbidities, level of social and community participation, self-efficacy and pre-stroke activity levels. Conclusion Personal identity, social engagement and community participation are important factors to consider when implementing a person-centred approach to increasing physical activity participation post-stroke.
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Affiliation(s)
- Karl Espernberger
- La Trobe University, School of Allied Health, Human Services and Sport, Melbourne, Victoria, Australia
- Donvale Rehabilitation Hospital (Ramsay Health), Donvale, VIC, Australia
| | - Natalie A Fini
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Casey L Peiris
- La Trobe University, School of Allied Health, Human Services and Sport, Melbourne, Victoria, Australia
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Ji P, Zhou S, Wang R, Fan H, Wang Y. Subjective Exercise Experience and Group Cohesion among Chinese Participating in Square Dance: A Moderated Mediation Model of Years of Participation and Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12978. [PMID: 36232277 PMCID: PMC9566402 DOI: 10.3390/ijerph191912978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: This study aimed to explore the relationship between years of participation, subjective exercise experience, and group cohesion among gender-specific square dance practitioners. (2) Methods: The Subjective Exercise Experience Questionnaire (SEEQ) and Group Environment Questionnaire (GEQ) were used to evaluate Subjective Exercise Experience (SEE) and group cohesion (GC). An analysis was conducted on 130 Chinese (63 males and 67 females) using multiple group analysis within a structural equation model. (3) Results: (a) The positive aspects of Subjective Exercise Experience (SEE) and Positive Well-Being (PWB), had a strongly positive effect on GC in both groups. The negative aspects of SEE, Psychological Fatigue (PF), and Psychological Distress (PD), had negative effects on GC. (b) Only for the male group was there an indirect effect of participation years on the association between SEE and GC in the model (a × b = 0.062, 95% CI [0.001, 0.181]; standard error (SE) = 0.062, p = 0.048). (c) The significant differences between paths coefficients were noticed in the association of years of participation with SEE (t = -2.043) and GC (t = -1.962). (4) Conclusion: Based on these results, gender differences in terms of the partial mediating role of adherence in the relationship of SEE and GC were presented for future research, fitness popularization, and society.
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Affiliation(s)
- Peiyao Ji
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Shihan Zhou
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Ruohang Wang
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Hongying Fan
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Yan Wang
- School of Art, Beijing Sport University, Beijing 100084, China
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Joundi RA, Patten SB, Lukmanji A, Williams JVA, Smith EE. Association Between Physical Activity and Mortality Among Community-Dwelling Stroke Survivors. Neurology 2021; 97:e1182-e1191. [PMID: 34380748 PMCID: PMC8480482 DOI: 10.1212/wnl.0000000000012535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE To determine the relationship between physical activity (PA) and mortality in community-dwelling stroke survivors. METHODS The Canadian Community Health Survey was used to obtain self-reported PA across 4 survey years and was linked to administrative databases to obtain prior diagnosis of stroke and subsequent all-cause mortality. PA was measured as metabolic equivalents (METs) per week and meeting minimal PA guidelines was defined as 10 MET-h/wk. Cox proportional hazard regression models and restricted cubic splines were used to determine the relationship between PA and all-cause mortality in respondents with prior stroke and controls, adjusting for sociodemographic factors, comorbidities, and functional health status. RESULTS The cohort included 895 respondents with prior stroke and 97,805 controls. Adhering to PA guidelines was associated with lower hazard of death for those with prior stroke (adjusted hazard ratio [aHR] 0.46, 95% confidence interval [CI] 0.29-0.73) and controls (aHR 0.69, 95% CI 0.62-0.76). There was a strong dose-response relationship in both groups, with a steep early slope and the vast majority of associated risk reduction occurring between 0 and 20 MET-h/wk. In the group of stroke respondents, PA was associated with greater risk reduction in those <75 years of age (aHR 0.21, 95% CI 0.10-0.43) compared to those ≥75 years of age (aHR 0.68, 95% CI 0.42-1.12). DISCUSSION PA was associated with lower all-cause mortality in an apparent dose-dependent manner among those with prior stroke, particularly in younger stroke survivors. Our findings support efforts towards reducing barriers to PA and implementation of PA programs for stroke survivors in the community. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that in community-dwelling survivors of stroke, adhering to physical activity guidelines was associated with lower hazard of death.
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Affiliation(s)
- Raed A Joundi
- From the Departments of Clinical Neurosciences (R.A.J., E.E.S.) and Community Health Sciences (R.A.J., S.B.P., A.L., J.V.A.W., E.E.S.), Cumming School of Medicine, University of Calgary, Canada.
| | - Scott B Patten
- From the Departments of Clinical Neurosciences (R.A.J., E.E.S.) and Community Health Sciences (R.A.J., S.B.P., A.L., J.V.A.W., E.E.S.), Cumming School of Medicine, University of Calgary, Canada
| | - Aysha Lukmanji
- From the Departments of Clinical Neurosciences (R.A.J., E.E.S.) and Community Health Sciences (R.A.J., S.B.P., A.L., J.V.A.W., E.E.S.), Cumming School of Medicine, University of Calgary, Canada
| | - Jeanne V A Williams
- From the Departments of Clinical Neurosciences (R.A.J., E.E.S.) and Community Health Sciences (R.A.J., S.B.P., A.L., J.V.A.W., E.E.S.), Cumming School of Medicine, University of Calgary, Canada
| | - Eric E Smith
- From the Departments of Clinical Neurosciences (R.A.J., E.E.S.) and Community Health Sciences (R.A.J., S.B.P., A.L., J.V.A.W., E.E.S.), Cumming School of Medicine, University of Calgary, Canada
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Chen S, Lv C, Wu J, Zhou C, Shui X, Wang Y. Effectiveness of a home-based exercise program among patients with lower limb spasticity post-stroke: A randomized controlled trial. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:1-7. [PMID: 32890770 DOI: 10.1016/j.anr.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of advanced practice nurse-guided home-based rehabilitation exercise program (HREPro) among patients with lower limb spasticity post-stroke. METHODS This randomized controlled study recruited 121 patients with lower limb spasticity post-stroke. Intervention (n = 59) and control (n = 62) groups underwent 12-month HREPro and conventional rehabilitation, respectively, after discharge. The Fugl-Meyer assessment of spasticity measurement, modified Ashworth scale of motor function, 10-Meter Walk Test of walking ability, and Barthel index of activities of daily living (ADL) were evaluated at 0, 3, 6, and 12 months after discharge. RESULTS Significant differences were found in spasticity degree, motor function, walking ability, and ADL at 6 and 12 months after discharge between the control and intervention groups. Lower limb spasticity and ADL in the intervention group were significantly improved. CONCLUSION HREPro is effective for rehabilitation of patients with lower limb spasticity post-stroke and has favorable home application.
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Affiliation(s)
- Shaomin Chen
- Department of Rehabilitation, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Chang Lv
- Department of Rehabilitation, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Jiaozhen Wu
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Chengwei Zhou
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Xiaolong Shui
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Yi Wang
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.
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Simpson DB, Breslin M, Cumming T, de Zoete SA, Gall SL, Schmidt M, English C, Callisaya ML. Sedentary time and activity behaviors after stroke rehabilitation: Changes in the first 3 months home. Top Stroke Rehabil 2020; 28:42-51. [PMID: 32578523 DOI: 10.1080/10749357.2020.1783917] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sedentary time is prevalent following stroke, limiting functional improvement, and increasing cardiovascular risk. At discharge we examined: 1) change in sedentary time and activity over the following 3 months' and 2) physical, psychological or cognitive factors predicting any change. A secondary aim examined cross-sectional associations between factors and activity at 3 months. METHODS People with stroke (n = 34) were recruited from two rehabilitation units. An activity monitor (ActivPAL3) was worn for 7 days during the first week home and 3 months later. Factors examined included physical, psychological, and cognitive function. Linear mixed models (adjusted for waking hours) were used to examine changes in sedentary time, walking, and step count over time. Interaction terms between time and each factor were added to the model to determine if they modified change over time. Linear regression was performed to determine factors cross-sectionally associated with 3-month activity. RESULTS ActivPAL data were available at both time points for 28 (82%) participants (mean age 69 [SD 12] years). At 3 months, participants spent 39 fewer minutes sedentary (95%CI -70,-8 p = .01), 21 minutes more walking (95%CI 2,22 p = .02) and completed 1112 additional steps/day (95%CI 268,1956 p = .01), compared to the first week home. No factors predicted change in activity. At 3 months, greater depression (β 22 mins (95%CI 8,36) p = .004) and slower gait speed (β - 43 mins 95%CI -59,-27 p ≤ 0.001) were associated with more sedentary time and less walking activity, respectively. CONCLUSIONS Sedentary time reduced and walking activity increased between discharge home and 3 months later. Interventions targeting mood and physical function may warrant testing to reduce sedentary behavior 3 months following discharge.
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Affiliation(s)
- Dawn B Simpson
- Menzies Institute of Medical Research, University of Tasmania , Hobart, Australia.,Physiotherapy Department, Royal Hobart Hospital, Tasmanian Health Service - South , Hobart, Australia
| | - Monique Breslin
- Menzies Institute of Medical Research, University of Tasmania , Hobart, Australia
| | - Toby Cumming
- Stroke Division, Florey Institute of Neurosciences and Mental Health , Heidleberg, Australia
| | - Sam A de Zoete
- Physiotherapy Department, Royal Hobart Hospital, Tasmanian Health Service - South , Hobart, Australia
| | - Seana L Gall
- Menzies Institute of Medical Research, University of Tasmania , Hobart, Australia
| | - Matthew Schmidt
- School of Health Sciences, University of Tasmania , Hobart, Australia
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle , Newcastle, Australia.,Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, University of Newcastle and Hunter Medical Research Institute , New Lambton Heights, Australia.,School of Health Sciences and Alliance for Research in Exercise, Nutrition and Activity, University of South Australia , Adelaide, Australia
| | - Michele L Callisaya
- Menzies Institute of Medical Research, University of Tasmania , Hobart, Australia.,Peninsula Clinical School, Central Clinical School, Monash University , Melbourne, Australia
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Lin S, Xiao LD, Chamberlain D. A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial. Trials 2020; 21:240. [PMID: 32131876 PMCID: PMC7057579 DOI: 10.1186/s13063-020-4156-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care. METHODS This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as "participant dyads", and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcome is changes in self-efficacy of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors' and quality of life, functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers' self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline. DISCUSSION This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers. TRIAL REGISTRATION The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000321145. Registered on 1 March 2019.
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Affiliation(s)
- Shuanglan Lin
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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Exercise and the Timing of Snack Choice: Healthy Snack Choice is Reduced in the Post-Exercise State. Nutrients 2018; 10:nu10121941. [PMID: 30544508 PMCID: PMC6315457 DOI: 10.3390/nu10121941] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/01/2018] [Accepted: 12/05/2018] [Indexed: 11/24/2022] Open
Abstract
Acute exercise can induce either a compensatory increase in food intake or a reduction in food intake, which results from appetite suppression in the post-exercise state. The timing of food choice—choosing for immediate or later consumption—has been found to influence the healthfulness of foods consumed. To examine both of these effects, we tested in our study whether the timing of food choice interacts with exposure to exercise to impact food choices such that choices would differ when made prior to or following an exercise bout. Visitors to a university recreational center were equipped with an accelerometer prior to their habitual workout regime, masking the true study purpose. As a reward, participants were presented with a snack for consumption after workout completion. Participants made their snack choice from either an apple or chocolate brownie after being pseudo-randomly assigned to choose prior to (“before”) or following workout completion (“after”). Complete data were available for 256 participants (54.7% male, 22.1 ± 3.1 years, 24.7 ± 3.7 kg/m2) who exercised 65.3 ± 22.5 min/session. When compared with “before,” the choice of an apple decreased (73.7% vs. 54.6%) and the choices of brownie (13.9% vs. 20.2%) or no snack (12.4% vs. 25.2%) increased in the “after” condition (χ2 = 26.578, p < 0.001). Our results provide support for both compensatory eating and exercise-induced anorexia. More importantly, our findings suggest that the choice of food for post-exercise consumption can be altered through a simple behavioral intervention.
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English C, Janssen H, Crowfoot G, Bourne J, Callister R, Dunn A, Oldmeadow C, Ong LK, Palazzi K, Patterson A, Spratt NJ, Walker FR, Dunstan DW, Bernhardt J. Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial. Int J Stroke 2018; 13:932-940. [DOI: 10.1177/1747493018798535] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Stroke survivors sit for long periods each day. Uninterrupted sitting is associated with increased risk of cardiovascular disease. Breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity has an immediate positive effect on blood pressure and plasma clotting factors in healthy, overweight, and type 2 diabetic populations. Aim We examined the effect of frequent, short bouts of light-intensity physical activity on blood pressure and plasma fibrinogen in stroke survivors. Methods Prespecified secondary analyses from a three-armed randomized, within-participant, crossover trial. Participants were 19 stroke survivors (nine female, aged 68 years old, 90% able to walk independently). The experimental conditions were sitting for 8 h uninterrupted, sitting with 3 min bouts of light-intensity exercise while standing every 30 min, or sitting with 3 min of walking every 30 min. Blood pressure was measured every 30 min over 8 h and plasma fibrinogen at the beginning, middle, and end of each day. Intention-to-treat analyses were performed using linear mixed models including fixed effects for condition, period, and order, and a random intercept for participant to account for repeated measures and missing data. Results Sitting with 3 min bouts of light-intensity exercise while standing every 30 min decreased systolic blood pressure by 3.5 mmHg (95% CI 1.7–5.4) compared with sitting for 8 h uninterrupted. For participants not taking antihypertensive medications, sitting with 3 min of walking every 30 min decreased systolic blood pressure by 5.0 mmHg (95% CI −7.9 to 2.0) and sitting with 3 min bouts light-intensity exercise while standing every 30 min decreased systolic blood pressure by 4.2 mmHg (95% CI −7.2 to −1.3) compared with sitting for 8 h uninterrupted. There was no effect of condition on diastolic blood pressure (p = 0.45) or plasma fibrinogen levels (p = 0.91). Conclusion Frequent, short bouts of light-intensity physical activity decreases systolic blood pressure in stroke survivors. However, before translation into clinical practice, the optimal duration and timing of physical activity bouts needs to be determined. Clinical trial registration Australian and New Zealand Clinical Trials Registry http://www.anzctr.org.au ANZTR12615001189516.
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Affiliation(s)
- Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - Heidi Janssen
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
- Hunter Stroke Service, Hunter New England Local Health District, Newcastle, Australia
| | - Gary Crowfoot
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - Josephine Bourne
- School of Biomedical Sciences and Pharmacy, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Ashlee Dunn
- School of Biomedical Sciences and Pharmacy, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support (CReDITSS), Hunter Medical Research Institute, Newcastle, Australia
| | - Lin K Ong
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - Kerrin Palazzi
- Clinical Research Design, Information Technology and Statistical Support (CReDITSS), Hunter Medical Research Institute, Newcastle, Australia
| | - Amanda Patterson
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Neil J Spratt
- Department of Neurology, John Hunter Hospital, Hunter New England Local Health District, Newcastle, Australia
| | - FR Walker
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - David W Dunstan
- Physical Activity, Baker Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Julie Bernhardt
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
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