1
|
Cheon DY, Han KD, Lee YJ, Lee JH, Park MS, Kim DY, Choi JH, Lee SJ, Yu KH, Han S, Lee S, Lee M. Association between physical activity changes and incident myocardial infarction after ischemic stroke: a nationwide population-based study. BMC Public Health 2024; 24:1241. [PMID: 38711032 DOI: 10.1186/s12889-024-18724-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The impact of changes in physical activity after ischemic stroke (IS) on the subsequent myocardial infarction (MI) risk is not fully understood. We aimed to investigate the effects of changes in physical activity on the risk of MI after acute IS using data from the Korean National Health Insurance Services Database. METHODS 224,764 patients newly diagnosed with IS between 2010 and 2016 who underwent two serial biannual health checkups were included. The participants were divided into four categories according to changes in their physical activity: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers. The primary outcome was a new diagnosis of incident MI. Multivariable Cox proportional models were used to assess the effects of changes in exercise habits on the risk of MI. RESULTS After a median of 4.25 years of follow-up, 6,611 (2.94%) MI cases were observed. After adjusting for confounders, new exercisers and exercise maintainers were significantly associated with a lower risk of incident MI than persistent non-exercisers (aHR, 0.849; 95% CI, 0.792-0.911; P-value < 0.001; and aHR, 0.746; 95% CI, 0.696-0.801; P-value < 0.001, respectively). Effects were consistent across sexes, more pronounced in those > 65 years. Notably, any level of physical activity after stroke was associated with a reduced MI risk compared to no exercise. CONCLUSIONS In this nationwide cohort study, commencing or sustaining physical activity after an IS corresponded to a diminished likelihood of subsequent MI development. Advocating physical activity in ambulatory stroke survivors could potentially attenuate the prospective risk of MI.
Collapse
Affiliation(s)
- Dae Young Cheon
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Kyung do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Yeon Jung Lee
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jeen Hwa Lee
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Myung Soo Park
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Do Young Kim
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jae Hyuk Choi
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Sook Jin Lee
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seongwoo Han
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Sunki Lee
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, Korea.
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
| |
Collapse
|
2
|
Galvão ACJ, Dias C, Miranda AL, Moura D, Palhares CVT, Oliveira Leopoldino A, Polese JC. Stroke related sarcopenia in individuals with different physical activity levels: A cross-sectional study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2084. [PMID: 38529736 DOI: 10.1002/pri.2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/21/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND AND OBJECTIVE Individuals after stroke are likely to deal with the possible development of sarcopenia and reduced physical activity levels. The purpose of this study was to compare sarcopenia of individuals with chronic stroke who were stratified according to their physical activity levels, and to evaluate the relationship between sarcopenia and physical activity levels. MATERIALS AND METHODS This cross-sectional study was conducted with individuals after chronic stroke recruited from the general community. Individuals were submitted to sarcopenia screening (SARC-F questionnaire) and assessment of physical activity levels (Human Activity Profile questionnaire) to classify the individuals as impaired, moderately active, and active according to their Adjusted Activity Status (AAS). ANOVA was used to investigate the sarcopenia between groups and Pearson's coefficient to investigate the association among variables. RESULTS Fifty-four individuals with a mean age of 56 ± 17.4 years were included. Twenty-one percent of the individuals were screened for sarcopenia. Inactive individuals had higher mean scores in the SARC-F (3.6 ± 2.1 points), whereas moderately active and active individuals presented lower mean scores in the same questionnaire, being 1.2 ± 1.1 points and 0.5 ± 0.7 points, respectively. A statistically significant inverse and high association was found between sarcopenia and physical activity levels (r = -0.716; p < 0.01). CONCLUSION Sarcopenia was found to be higher in individuals after chronic stroke with lower physical activity levels considered inactive when compared to individuals with higher physical activity levels. Furthermore, there was an inverse relationship between sarcopenia and physical activity level in stroke survivors.
Collapse
Affiliation(s)
| | - Camila Dias
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Luiza Miranda
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela Moura
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Amanda Oliveira Leopoldino
- Post-Graduate Program of Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Janaine Cunha Polese
- Physiotherapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
3
|
Barclay R, Webber SC, Ripat J, Nowicki S, Tate R. Self-reported factors associated with community ambulation after stroke: The Canadian Longitudinal Study on Aging. PLoS One 2024; 19:e0299569. [PMID: 38547187 PMCID: PMC10977696 DOI: 10.1371/journal.pone.0299569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/13/2024] [Indexed: 04/02/2024] Open
Abstract
Community ambulation is frequently limited for people with stroke. It is, however, considered important to people with stroke. The objectives were to identify factors associated with self-reported community ambulation in Canadians aged 45+ with stroke and to identify factors associated with community ambulation specific to Canadian males and to Canadian females with stroke. Data were utilized from the Canadian Longitudinal Study on Aging Tracking Cohort. Multivariate logistic regression models were developed for community ambulation. Mean age was 68 (SE 0.5) years (45% female). In the final community ambulation model (n = 855), factors associated with being less likely to 'walk outdoors sometimes or often' included difficulty or being unable to walk 2-3 blocks (decreased endurance) vs. no difficulty. Being more likely to walk outdoors was associated with 'better weather' months and being 55-64 years of age vs 75-85. Differences were noted between the models of only males and only females. Decreased walking endurance is associated with a decreased likelihood of walking in the community-a factor that can be addressed by rehabilitation professionals and in community based programs.
Collapse
Affiliation(s)
- Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sandra C. Webber
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Scott Nowicki
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert Tate
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
4
|
Hokstad A, Thommessen B, Ihle-Hansen H, Indredavik B, Døhl Ø, Askim T. Reduced physical activity level was associated with poorer quality of life during the early phase of the COVID-19 pandemic: a sub-study of the last-long trial. J Rehabil Med 2023; 55:jrm12352. [PMID: 38058014 PMCID: PMC10719864 DOI: 10.2340/jrm.v55.12352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/20/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES To assess how physical activity levels changed in a stroke cohort during the COVID-19 (SARS-CoV-2) pandemic, and how these changes were associated with quality of life (QoL). METHODS Between March and July 2021, 150 patients with stroke already included in the Life after Stroke (LAST-long) trial in Norway were invited to participate in this cross-sectional survey. Participants were asked to complete a questionnaire assessing changes in physical activity and self-reported health following the pandemic. Univariate and multivariate logistic regression analyses were used to explore the association between physical activity, loneliness, mental health, social activity and QoL. RESULTS In all, 118 (79%) participants completed the questionnaire. A total of 80 (68%) reported less physical activity, 46 (39%) felt lonelier, and 43 (37%) reported worse mental health, while 50 (42%) reported reduced QoL compared with before the lockdown. In the univariate analyses less physical activity, feeling lonelier and changes in mental health were associated with reduced QoL. In the multivariate analysis only less physical activity odds ratio (OR) = 4.04 (95% confidence interval (95% CI) 1.44-11.34, p = 0.008) was significantly associated with reduced QoL. CONCLUSION More than two-thirds of patients with stroke reported reduced physical activity during the COVID-19 pandemic, and less physical activity was strongly associated with reduced QoL.
Collapse
Affiliation(s)
- Anne Hokstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Håkon Ihle-Hansen
- Stroke Unit, Medical Department, Bærum Hospital, Vestre Viken Hospital Trust
| | - Bent Indredavik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Stroke, Clinic of Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department Department of Medical Quality Registries, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øystein Døhl
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Finance, City of Trondheim, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
5
|
Koffman LJ, Crainiceanu CM, Roemmich RT, French MA. Identifying Unique Subgroups of Individuals With Stroke Using Heart Rate and Steps to Characterize Physical Activity. J Am Heart Assoc 2023; 12:e030577. [PMID: 37681556 PMCID: PMC10547293 DOI: 10.1161/jaha.123.030577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023]
Abstract
Background Low physical activity (PA) is associated with poor health outcomes after stroke. Step counts are a common metric of PA; however, other physiologic signals (eg, heart rate) may help to identify subgroups of individuals poststroke at varying levels of risk of poor health outcomes. Here, we aimed to identify clinically relevant subgroups of individuals poststroke based on PA profiles that leverage multiple data sources, including step count and heart rate data, from wearable devices. Methods and Results Seventy individuals poststroke participated. Participants wore a Fitbit Inspire 2 for 1 year and completed clinical assessments. We defined a group-based steps-per-minute threshold and an individual heart rate threshold to categorize each minute of PA into 1 of 4 states: high steps/high heart rate, low steps/low heart rate, high steps/low heart rate, and low steps/high heart rate. We used the proportion of time spent in each state along with steps per day, sedentary time, mean steps among minutes with high steps and high heart rate, and resting heart rate in a k-means clustering algorithm to identify subgroups and compared Activity Measure for Post-Acute Care Mobility T Score, Stroke Impact Scale, and gait speed among subgroups. We identified 3 subgroups, Active (n=8), Sedentary (n=29), and Deconditioned (n=33), which differed significantly on all clustering variables except resting heart rate. We observed significant differences in Activity Measure for Post-Acute Care Mobility T scores between subgroups, with the Deconditioned subgroup exhibiting the lowest score. Conclusions Quantifying PA with heart rate and step count using readily available wearable devices can identify clinically meaningful subgroups of individuals poststroke.
Collapse
Affiliation(s)
- Lily J. Koffman
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | | | - Ryan T. Roemmich
- Department of Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimoreMD
- Center for Movement StudiesKennedy Krieger InstituteBaltimoreMD
| | - Margaret A. French
- Department of Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimoreMD
| |
Collapse
|
6
|
Lee HH, Lee KN, Kim JS, Cheung DY, Kwon HS, Lee BI, Cho YS, Park SH, Han K, Kim JI. Association between regular physical activity and lower incidence of colorectal cancer in patients with diabetes mellitus: a nationwide cohort study. Colorectal Dis 2023; 25:1588-1597. [PMID: 37277925 DOI: 10.1111/codi.16631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023]
Abstract
AIM The aim of this work was to investigate the association between changes in physical activity (PA) status and the development of colorectal cancer (CRC) in patients with diabetes. METHOD This nationwide population study included 1 439 152 patients with diabetes who underwent a health screening provided by the Korean National Health Insurance Service between January 2009 and December 2012 and a follow-up screening after 2 years. Based on changes in PA status, participants were categorized into four groups: remained inactive, remained active, active-to-inactive and inactive-to-active. RESULTS During the median follow-up period of 5.2 years, 38 244 new cases of CRC were diagnosed. Compared with the remained inactive group, among the three other groups, the remained active group had the lowest risk of CRC [adjusted hazard ratio (aHR) 0.93; 95% CI 0.90-0.96], followed by the inactive-to-active group (aHR 0.97; 95% CI 0.94-1.00) and active-to-inactive group (aHR 0.99; 95% CI 0.96-1.02), after adjusting for confounding variables (p = 0.0007). This reduction in cancer incidence in the remained active group was observed for both rectal cancer (aHR 0.87, 95% CI 0.79-0.95) and colon cancer (aHR 0.93, 95% CI 0.90-0.97), irrespective of sex. In terms of the intensity and amount of PA, moderate intensity PA was the most effective, and a positive correlation was found between the amount of PA and the reduction in CRC incidence. CONCLUSION Regular PA was independently associated with a decreased risk of CRC in patients with diabetes. The intensity and amount of physical activity both play a role in reducing the risk.
Collapse
Affiliation(s)
- Han Hee Lee
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyu-Na Lee
- Department of Biomedicine & Health Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jin Su Kim
- Division of Gastroenterology, Department of Internal Medicine, Eunpyung St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dae Young Cheung
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Bo-In Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Young-Seok Cho
- Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Soo-Heon Park
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Jin Il Kim
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
7
|
Risk of dementia according to the smoking habit change after ischemic stroke: a nationwide population-based cohort study. Sci Rep 2022; 12:22422. [PMID: 36575201 PMCID: PMC9794689 DOI: 10.1038/s41598-022-27083-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/26/2022] [Indexed: 12/28/2022] Open
Abstract
There is a paucity of research regarding the association between the risk of incident dementia and changes in smoking habits in the acute ischemic stroke population. We aimed to investigate the effects of smoking habit change on the risk of incident dementia in an ischemic stroke population using data from the Korean National Health Insurance Services Database. This nationwide population-based cohort study included 197,853 patients with ischemic stroke. The patients were divided into never smokers, former smokers, smoking quitters, sustained smokers, and new smokers, based on the 2-year change in smoking status between the two consecutive health examinations before and after the index stroke. The patients were followed up from the index date to 2018 to assess the development of dementia. Dementia was further categorized into Alzheimer's, vascular, and other types of dementia according to the International Classification of Diseases, Tenth Revision diagnosis. Multivariable Cox proportional hazards models were used to assess the association between changes in smoking habits and the risk of dementia. After a median of 4.04 years of follow-up, 19,595 (9.9%) dementia cases were observed. Among them, 15,189 (7.7%) were diagnosed with Alzheimer's disease dementia and 2719 (1.4%) were diagnosed with vascular dementia. After adjusting for covariates, including age, sex, alcohol intake habits, cigarette pack-year, regular physical activity, income, history of hypertension, diabetes mellitus, dyslipidemia, and chronic kidney disease, new smokers, sustained smokers, and smoking quitters were significantly associated with a higher risk of all-cause dementia than never smokers (adjusted hazard ratio [aHR] 1.395, 95% confidence interval [CI] 1.254-1.552; aHR 1.324, 95% CI 1.236-1.418; and aHR 1.170, 95% CI 1.074-1.275, respectively). Similar trends were observed for both Alzheimer's dementia and vascular dementia, but the association between new smokers and vascular dementia was not significant. The impact of smoking habit change was more prominent in the 40-65-year-old group. New and sustained smokers had a substantially higher risk of incident dementia after ischemic stroke than never smokers. Smoking quitters also had an elevated risk of incident dementia, but the detrimental effects were lower than those in new and sustained smokers.
Collapse
|
8
|
Cha S, Chang WK, Cho HM, Jung YS, Kang M, Paik NJ, Kim WS. The effect of a telephone-based intervention on physical activity after stroke. PLoS One 2022; 17:e0276316. [PMID: 36264990 PMCID: PMC9584526 DOI: 10.1371/journal.pone.0276316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/05/2022] [Indexed: 11/18/2022] Open
Abstract
Despite the effectiveness of telephone-based interventions for medical adherence and improved blood pressure, studies on the effect of such interventions on physical activity (PA) are needed. Therefore, we investigated the impact of a telephone-based intervention on PA in patients with subacute stroke. This pre-post study included patients who participated in an education program for stroke rehabilitation before being discharged to home, with a modified Rankin scale (mRS) score of ≤ 3. Patients hospitalized in 2020 (intervention group) received a nurse-led telephone-based intervention with a PA measurement once monthly during the 3 months after discharge. Those hospitalized in 2019 (historical controls) only received a PA measurement 3 months after discharge. Physical activity was assessed via a questionnaire by phone. In addition, demographics, medical history, smoking, mRS scores, and Patient Health Questionnaire-9 data were collected. The study included 139 participants (73 in intervention, 66 in control). The intervention group had a higher proportion of patients with mRS of 0-1 and a shorter length of hospital stay than the historical controls. Three months post-discharge, a significantly higher proportion of participants were physically active in the intervention group (48 [71.6%] vs. control group, 25 [34.7%]). In addition, the intervention group had a significantly higher median energy expenditure (924 vs. 297 MET-min/week) than the control group. The OR of the intervention for achieving 'physically active' individuals was 4.749 (95% CI, 2.313-9.752) before and 5.222 (95% CI, 1.892-14.419) after adjusting for possible confounders. A telephone-based intervention improved PA three months after stroke. Further studies with larger sample size and long-term follow-up are needed.
Collapse
Affiliation(s)
- Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee-Mun Cho
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun-Sun Jung
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Miji Kang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
| |
Collapse
|
9
|
Reicherzer L, Wirz M, Wieber F, Graf ES. Facilitators and barriers to health enhancing physical activity in individuals with severe functional limitations after stroke: A qualitative study. Front Psychol 2022; 13:982302. [PMID: 36337530 PMCID: PMC9628747 DOI: 10.3389/fpsyg.2022.982302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/29/2022] [Indexed: 11/28/2022] Open
Abstract
Background Patients with chronic conditions are less physically active than the general population despite knowledge of positive effects on physical and mental health. There is a variety of reasons preventing people with disabilities from achieving levels of physical activities resulting in health benefits. However, less is known about potential facilitators and barriers for physical activity (PA) in people with severe movement impairments. The aim of this study was to identify obstacles and facilitators of PA in individuals with severe disabilities. Materials and methods Using a qualitative approach to explore individuals’ subjective perspectives in depth, five community-dwelling adults (age 52–72, 2 female, 3 male) living with chronic mobility impairments after stroke that restrict independent PA were interviewed. A semi structured topic guide based on the theoretical domains framework was utilized. The interview data was analyzed thematically, and the theoretical domains framework constructs were mapped onto the main and sub-categories. Results The six main categories of facilitators and barriers along the capability, opportunity, motivation–behavior (COM-B) framework were: (1) physical capabilities, (2) psychological capabilities, (3) motivation reflective, (4) motivation automatic, (5) opportunity physical, and (6) opportunity social. The physical capabilities to independently perform PA were variable between participants but were not necessarily perceived as a barrier. Participants were highly motivated to maintain and/or increase their abilities to master their everyday lives as independently as possible. It became clear that a lack of physical opportunities, such as having access to adequate training facilities can present a barrier. Social opportunities in the form of social support, social norms, or comparisons with others can act as both facilitators and barriers. Conclusion While confirming known barriers and facilitators that impact the ability of individuals with functional limitations to be active, the findings highlight the need and opportunities for comprehensive service models based on interdisciplinary collaborations.
Collapse
Affiliation(s)
- Leah Reicherzer
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Markus Wirz
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Frank Wieber
- Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Social Psychology and Motivation Lab, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Eveline S. Graf
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- *Correspondence: Eveline S. Graf,
| |
Collapse
|
10
|
Lee KE, Choi M, Jeoung B. Effectiveness of Rehabilitation Exercise in Improving Physical Function of Stroke Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12739. [PMID: 36232038 PMCID: PMC9566624 DOI: 10.3390/ijerph191912739] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Rehabilitation is a crucial part of recovery for stroke survivors, and numerous studies have examined various exercises and treatments of stroke. In addition, it is very important for patients to choose the timing of rehabilitation and what kind of rehabilitation they will proceed with. The purpose of the current study is to examine research investigating the effects of rehabilitation exercise programs in recovery of physical function in patients with stroke, based on aspects of their physical function, physical strength, and daily activities, and systematically examine their effects. Therefore, through systematic review, we have investigated the effects of interventions in rehabilitation exercise programs for recovery of physical function in patients with stroke. We collected relevant publications through the databases MEDLINE/PubMed and Google scholar. Twenty-one articles were ultimately selected for the analysis. We classified the rehabilitation programs and identified the trends of treatment for stroke survivors. Our review indicated that task-oriented therapy is still dominant, but various types of combined rehabilitations have been attempted. In addition, it was identified that physical and active rehabilitation were required rather than unconditional rest, even at an early stage. Home-based treatment was used for rapid recovery and adaptation to daily life during the mid-term period.
Collapse
Affiliation(s)
- Kyung Eun Lee
- Department Sport Industry Studies, Yonsei University, Seoul 03722, Korea
| | - Muncheong Choi
- Department Exercise Rehabilitation, Gachon University, Incheon 21936, Korea
| | - Bogja Jeoung
- Department Exercise Rehabilitation, Gachon University, Incheon 21936, Korea
| |
Collapse
|