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Kanai M, Nozoe M, Ohtsubo T, Ueno K, Nakayama M, Yamashita M, Kamiya K. Effects of a multidisciplinary intervention to promote physical activity in patients with stroke undergoing rehabilitation: study protocol for the ActivePAS pilot randomised controlled trial. BMJ Open Sport Exerc Med 2022; 8:e001401. [PMID: 36312793 PMCID: PMC9608546 DOI: 10.1136/bmjsem-2022-001401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Physical activity after stroke is related to functional recovery and outcomes. To optimise physical activity adapted to a patient's walking ability and characteristics, multidisciplinary support and interventions are required. The Activate Physical Activity for Stroke pilot randomised controlled trial aims to assess the safety and feasibility of a multidisciplinary intervention that promotes physical activity in patients who had a stroke undergoing rehabilitation. Methods and analysis This single-centre, randomised controlled trial will enrol 32 patients who had a stroke undergoing rehabilitation. Patients who had a stroke with the ability to walk 50 m with at least hand assistance, regardless of the use of braces or walking aids, and aged≥20 years will be randomly allocated to a multidisciplinary intervention group or control group. Patients in the intervention group will receive instructions for the self-monitoring of hospitalised physical activity and support to promote physical activity by multidisciplinary staff. The primary outcome of the present study is the safety (adverse events) and feasibility (retention and completion rates) of the multidisciplinary intervention. We assess physical activity using a triaxial accelerometer (UW-204NFC, A&D Company) as one of the secondary outcomes. Ethics and dissemination The present study has been approved by the Research Ethics Committee of Konan Women's University and the Ethics Committee of Nishi-Kinen Port Island Rehabilitation Hospital. We will disseminate the results of the present study through a peer-reviewed manuscript and presentations at international conferences. Trial registration number UMIN000046731.
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Affiliation(s)
- Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Takuro Ohtsubo
- Department of Rehabilitation, Nishi-Kinen Port Island Rehabilitation Hospital, Kobe, Japan
| | - Katsuhiro Ueno
- Department of Rehabilitation, Nishi-Kinen Port Island Rehabilitation Hospital, Kobe, Japan
| | - Mai Nakayama
- Department of Rehabilitation, Nishi-Kinen Port Island Rehabilitation Hospital, Kobe, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
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Peng T, Li S, Liu L, Yang C, Farhan M, Chen L, Su Q, Zheng W. Artemisinin attenuated ischemic stroke induced cell apoptosis through activation of ERK1/2/CREB/BCL-2 signaling pathway in vitro and in vivo. Int J Biol Sci 2022; 18:4578-4594. [PMID: 35864966 PMCID: PMC9295073 DOI: 10.7150/ijbs.69892] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/27/2022] [Indexed: 12/18/2022] Open
Abstract
Ischemic stroke is characterized by the presence of both brain ischemic and reperfusion-induced injuries in the brain, leading to neuronal dysfunction and death. Artemisinin, an FDA-approved antimalarial drug, has been reported to have neuroprotective properties. However, the effect of artemisinin on ischemic stroke is not known. In the present study, we investigated the effect of artemisinin on ischemic stroke using an oxygen-glucose deprivation/reperfusion (OGD/RP) cellular model and a mouse middle cerebral artery occlusion (MCAO) animal model and examined the underlying mechanisms. The obtained results revealed that a subclinical antimalarial concentration of artemisinin increased cell viability and decreased LDH release and cell apoptosis. Artemisinin also attenuated the production of reactive oxygen species (ROS) and the loss of mitochondrial membrane potential (Δψm). Importantly, artemisinin attenuated the infarction volume and the brain water content in the MCAO animal model. Artemisinin also improved neurological and behavioural outcomes and restored grasp strength and the recovery of motor function in MCAO animals. Furthermore, artemisinin treatment significantly inhibited the molecular indices of apoptosis, oxidative stress and neuroinflammation and activated the ERK1/2/CREB/BCL-2 signaling pathway. Further validation of the involved signaling pathway by the ERK1/2 inhibitor PD98059 revealed that inhibiting the ERK1/2 signaling pathway or silencing ERK1/2 reversed the neuroprotective effects of artemisinin. These results indicate that artemisinin provides neuroprotection against ischemic stroke via the ERK1/2/CREB/BCL-2 signaling pathway. Our study suggests that artemisinin may play an important role in the prevention and treatment of stroke.
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Affiliation(s)
- Tangming Peng
- Faculty of Health Science, University of Macau, Taipa, Macau, China.,Department of Neurosurgery, Affiliated Hospital of Southwest Medical University and Neurosurgical Clinical Research Center of Sichuan Province, Luzhou, China
| | - Shuai Li
- Faculty of Health Science, University of Macau, Taipa, Macau, China
| | - Linlin Liu
- Faculty of Health Science, University of Macau, Taipa, Macau, China
| | - Chao Yang
- Faculty of Health Science, University of Macau, Taipa, Macau, China
| | - Mohd Farhan
- Faculty of Health Science, University of Macau, Taipa, Macau, China
| | - Ligang Chen
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University and Neurosurgical Clinical Research Center of Sichuan Province, Luzhou, China
| | - Qiaozhu Su
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, United Kingdom
| | - Wenhua Zheng
- Faculty of Health Science, University of Macau, Taipa, Macau, China
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Yamada R, Shimizu S, Suzuki Y, Nakachi Y, Takemura N, Taira K, Yamazato T, Shimabukuro M, Tsunoda S, Shimose R, Ogura M, Higa J, Nakanishi T, Matsunaga A. Factors related to daily step counts of stroke patients during hospitalization in a convalescent rehabilitation ward. J Stroke Cerebrovasc Dis 2022; 31:106398. [PMID: 35219974 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/29/2022] [Accepted: 02/05/2022] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Clarifying the factors related to decreased physical activity in post-stroke patients is essential for effective disease management. This study aimed to examine the factors influencing the amount of daily steps taken by post-stroke patients in a convalescent rehabilitation ward during activities other than rehabilitation (non-rehabilitation steps). MATERIALS AND METHODS Eighty-nine post-stroke patients (60.8±14.4 years; 55 men) were enrolled. The inclusion criteria were walking independently within the ward and having a walking speed of ≥24 m/min. Data on patient clinical characteristics including age, sex, body mass index, stroke type, hemiparetic side, and time from stroke onset were collected. Stroke impairment and motor and cognitive functional disabilities were assessed using the Stroke Impairment Assessment Set and the Functional Independence Measure, respectively. The non-rehabilitation steps were calculated by subtracting the steps during the rehabilitation activities from the total steps using Fitbit Flex2. RESULTS The average number of non-rehabilitation steps was 4,523±2,339 steps/day. The hierarchical multiple regression analysis revealed that sex, motor disability, and the interaction term of stroke impairment with cognitive disability were significantly related to non-rehabilitation steps. Simple slope analysis demonstrated that the stroke impairment slope was steeper at lower levels than at higher levels of cognitive disability for non-rehabilitation steps. CONCLUSIONS In addition to independent effects of sex and motor disability, this study found that stroke impairment and cognitive disability were interactively related to non-rehabilitation steps in post-stroke patients in a convalescent rehabilitation ward. These findings may provide useful information for managing physical activity in post-stroke patients after hospital discharge.
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Affiliation(s)
- Ryuichiro Yamada
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Shinobu Shimizu
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Yuta Suzuki
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Yuki Nakachi
- Department of Rehabilitation, Shimanokaze Daycare Center, Okinawa, Japan
| | - Nami Takemura
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Katsuya Taira
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Tomoya Yamazato
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Michiru Shimabukuro
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Satoshi Tsunoda
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Ryota Shimose
- Department of Physical Therapy, Okayama Healthcare Professional University, Okayama, Japan
| | - Misao Ogura
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Jun Higa
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Takayuki Nakanishi
- Department of Rehabilitation, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
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Veerubhotla A, Krantz A, Ibironke O, Pilkar R. Wearable devices for tracking physical activity in the community after an acquired brain injury: A systematic review. PM R 2021; 14:1207-1218. [PMID: 34689426 DOI: 10.1002/pmrj.12725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/20/2021] [Accepted: 10/04/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The application of wearable devices in individuals with acquired brain injury (ABI) resulting from stroke or traumatic brain injury (TBI) for monitoring physical activity (PA) has been relatively recent. The current systematic review aims to provide insights into the adaption of these devices, outcome metrics, and their transition from the laboratory to the community for PA monitoring of individuals with ABI. LITERATURE SURVEY The PubMed and Google Scholar databases were systematically reviewed using appropriate search terms. A total of 20 articles were reviewed from the past 15 years. METHODOLOGY Articles were classified into three categories - PA measurement studies, PA classification studies, and validation studies. The quality of studies was assessed using a quality appraisal checklist. SYNTHESIS It was found that the transition of wearable devices from in-lab to community-based studies in individuals with stroke has started but is not widespread. The transition of wearable devices in the community has not yet started for individuals with TBI. Accelerometer-based devices were more frequently chosen than pedometers and inertial measurement units. No consensus on a preferred wearable device (make or model) or wear location could be identified, though step count was the most common outcome metric. The accuracy and validity of most outcome metrics used in the community were not reported for many studies. CONCLUSIONS To facilitate future studies use wearable devices for PA measurement in the community, we recommend that researchers provide details on the accuracy and validity of the outcome metrics specific to the study environment. Once the accuracy and validity are established for a specific population, wearable devices and their derived outcomes can provide objective information on mobility impairment as well as the effect of rehabilitation in the community. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Akhila Veerubhotla
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, USA.,Research Assistant Professor, Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, USA
| | - Amanda Krantz
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, USA
| | - Oluwaseun Ibironke
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, USA
| | - Rakesh Pilkar
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, USA.,Assistant Research Professor, Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, USA
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Ashizawa R, Honda H, Take K, Yoshizawa K, Ooba Y, Kameyama Y, Yoshimoto Y. Approaches to Promote Reduction in Sedentary Behavior in Patients With Minor Ischemic Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 103:255-262.e4. [PMID: 34562434 DOI: 10.1016/j.apmr.2021.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether an approach that promotes reduction in sedentary behavior (SB) during hospitalization and after hospital discharge reduces SB in patients with minor ischemic stroke (MIS) compared with an approach that promotes an increase in physical activity levels. DESIGN Randomized controlled trial design. SETTING During hospitalization and after hospital discharge. PARTICIPANTS We randomly assigned patients (N=61) with MIS (average age, 71.3±8.3y; 65.6% men) admitted to an acute hospital to either the intervention group (reduced SB, n=31) or the control group (increased physical activity levels, n=30). INTERVENTIONS During hospitalization, the intervention group received education on reducing SB, goal setting for SB after hospital discharge, and self-monitoring of SB and step count. In contrast, the control group received education on increasing physical activity levels and self-monitoring of step count. Patients in both groups wore an accelerometer during hospitalization until 3 months after hospital discharge. The intervention group received self-monitoring of SB and step count, stickers including information about reducing their SB, and phone calls once every 2 weeks for encouragement and feedback. The control group only wore the accelerometer. MAIN OUTCOME MEASURES The primary outcome was SB (in percentage) at 3 months after hospital discharge. RESULTS There was an interaction between the 2 groups for SB. Compared with the control group, the intervention group showed a significantly reduced SB (intervention group: baseline, 70.5%; 3 months after hospital discharge, 48.6%; control group: baseline, 71.5%; 3 months after hospital discharge, 57.5%; F value=5.981; P=.018). CONCLUSIONS The results suggested that an approach that promotes SB reduction during hospitalization and after hospital discharge is effective in reducing SB in patients with MIS 3 months after hospital discharge.
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Affiliation(s)
- Ryota Ashizawa
- Department of Rehabilitation, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka; Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka.
| | - Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka; Department of Rehabilitation, Hanadaira Care Center, Hamamatsu, Shizuoka
| | - Koki Take
- Visiting Nurse Station Takaoka, Seirei Care Center Takaoka, Hamamatsu, Shizuoka
| | - Kohei Yoshizawa
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka; Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshihiro Ooba
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan
| | - Yuto Kameyama
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka; Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshinobu Yoshimoto
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka
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Saunders DH, Mead GE, Fitzsimons C, Kelly P, van Wijck F, Verschuren O, Backx K, English C. Interventions for reducing sedentary behaviour in people with stroke. Cochrane Database Syst Rev 2021; 6:CD012996. [PMID: 34184251 PMCID: PMC8238669 DOI: 10.1002/14651858.cd012996.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Stroke survivors are often physically inactive as well as sedentary,and may sit for long periods of time each day. This increases cardiometabolic risk and has impacts on physical and other functions. Interventions to reduce or interrupt periods of sedentary time, as well as to increase physical activity after stroke, could reduce the risk of secondary cardiovascular events and mortality during life after stroke. OBJECTIVES To determine whether interventions designed to reduce sedentary behaviour after stroke, or interventions with the potential to do so, can reduce the risk of death or secondary vascular events, modify cardiovascular risk, and reduce sedentary behaviour. SEARCH METHODS In December 2019, we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, Conference Proceedings Citation Index, and PEDro. We also searched registers of ongoing trials, screened reference lists, and contacted experts in the field. SELECTION CRITERIA Randomised trials comparing interventions to reduce sedentary time with usual care, no intervention, or waiting-list control, attention control, sham intervention or adjunct intervention. We also included interventions intended to fragment or interrupt periods of sedentary behaviour. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies and performed 'Risk of bias' assessments. We analyzed data using random-effects meta-analyses and assessed the certainty of the evidence with the GRADE approach. MAIN RESULTS We included 10 studies with 753 people with stroke. Five studies used physical activity interventions, four studies used a multicomponent lifestyle intervention, and one study used an intervention to reduce and interrupt sedentary behaviour. In all studies, the risk of bias was high or unclear in two or more domains. Nine studies had high risk of bias in at least one domain. The interventions did not increase or reduce deaths (risk difference (RD) 0.00, 95% confidence interval (CI) -0.02 to 0.03; 10 studies, 753 participants; low-certainty evidence), the incidence of recurrent cardiovascular or cerebrovascular events (RD -0.01, 95% CI -0.04 to 0.01; 10 studies, 753 participants; low-certainty evidence), the incidence of falls (and injuries) (RD 0.00, 95% CI -0.02 to 0.02; 10 studies, 753 participants; low-certainty evidence), or incidence of other adverse events (moderate-certainty evidence). Interventions did not increase or reduce the amount of sedentary behaviour time (mean difference (MD) +0.13 hours/day, 95% CI -0.42 to 0.68; 7 studies, 300 participants; very low-certainty evidence). There were too few data to examine effects on patterns of sedentary behaviour. The effect of interventions on cardiometabolic risk factors allowed very limited meta-analysis. AUTHORS' CONCLUSIONS Sedentary behaviour research in stroke seems important, yet the evidence is currently incomplete, and we found no evidence for beneficial effects. Current World Health Organization (WHO) guidelines recommend reducing the amount of sedentary time in people with disabilities, in general. The evidence is currently not strong enough to guide practice on how best to reduce sedentariness specifically in people with stroke. More high-quality randomised trials are needed, particularly involving participants with mobility limitations. Trials should include longer-term interventions specifically targeted at reducing time spent sedentary, risk factor outcomes, objective measures of sedentary behaviour (and physical activity), and long-term follow-up.
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Affiliation(s)
- David H Saunders
- Physical Activity for Health Research Centre (PAHRC), University of Edinburgh, Edinburgh, UK
| | - Gillian E Mead
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Claire Fitzsimons
- Physical Activity for Health Research Centre (PAHRC), University of Edinburgh, Edinburgh, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre (PAHRC), University of Edinburgh, Edinburgh, UK
| | - Frederike van Wijck
- Institute for Applied Health Research and the School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Karianne Backx
- Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Coralie English
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research Institute, Melbourne and Newcastle, Australia
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Kanai M, Izawa KP, Kubo H, Nozoe M, Mase K, Shimada S. Association of Health Utility Score with Physical Activity Outcomes in Stroke Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E251. [PMID: 33396274 PMCID: PMC7796267 DOI: 10.3390/ijerph18010251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 12/22/2022]
Abstract
Health-related quality of life (HRQoL) after stroke tends to vary across studies or across stages of stroke. It is useful to use the health utility score to compare HRQoL across studies. Physical activity after stroke also tends to vary similarly. The purpose of the present study was to determine associations between the health utility score and physical activity outcomes in stroke survivors. This cross-sectional study recruited stroke survivors who could ambulate outside, free of assistance. We assessed the health utility score with the EuroQoL 5-Dimension 3-Level questionnaire. The physical activity outcomes were the number of steps taken and duration of moderate-to-vigorous physical activity (MVPA) as measured with an accelerometer. Multiple linear regression analyses were used to determine whether the physical activity outcomes were independently associated with the health utility score. Fifty patients (age: 68.0 years; 40 men, 10 women) were included. Multiple linear regression analysis showed the health utility score to be significantly associated with the number of steps taken (β = 0.304, p = 0.035) but not with MVPA. This is the first study to examine the association between the health utility score and objectively measured physical activity in stroke survivors. Promoting physical activity especially by increasing the number of steps taken might be a priority goal in improving a patient's health utility score after stroke.
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Affiliation(s)
- Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan; (M.K.); (M.N.); (K.M.)
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
| | - Kazuhiro P. Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan;
| | - Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan; (M.K.); (M.N.); (K.M.)
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan; (M.K.); (M.N.); (K.M.)
| | - Shinichi Shimada
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan
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Association of Perceived Built Environment Attributes with Objectively Measured Physical Activity in Community-Dwelling Ambulatory Patients with Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203908. [PMID: 31618860 PMCID: PMC6843772 DOI: 10.3390/ijerph16203908] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/09/2019] [Accepted: 10/13/2019] [Indexed: 12/11/2022]
Abstract
There is little evidence on how perceptions of the built environment may influence physical activity among post-stroke patients. This study aimed to explore the associations between perceived built environment attributes and objectively measured physical activity outcomes in community-dwelling ambulatory patients with stroke. This cross-sectional study recruited patients who could walk outside without assistance. We assessed both objectively measured physical activity outcomes such as number of steps and duration of moderate-to-vigorous physical activity (MVPA) with an accelerometer and the patients’ perceived surrounding built environment with the International Physical Activity Questionnaire Environmental Module. Sixty-one patients (67.0 years old) were included. The multiple linear regression analysis showed significant associations of the presence of sidewalks (β = 0.274, p = 0.016) and access to recreational facilities (β = 0.284, p = 0.010) with the number of steps taken (adjusted R2 = 0.33). In contrast, no significant associations were found between perceived built environment attributes and MVPA. These findings may help to suggest an approach to promote appropriate physical activity in patients with stroke depending on their surrounding built environment.
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