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Kossi O, Bonnechère B, Agbetou M, Somasse R, Hokpo A, Houehanou YCN, Adoukonou T, Mandigout S. Relationships between cardiorespiratory fitness, physical activity practices, and functional outcomes one-year post-stroke in northern Benin: A case-control study. Top Stroke Rehabil 2024; 31:104-115. [PMID: 37120850 DOI: 10.1080/10749357.2023.2207286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Currently, little is known on the relationships between cardiorespiratory fitness (CF), physical activity (PA), and functional outcomes after stroke, especially in low- and middle-income countries. OBJECTIVES We examine the relationships between CF, PA, and functional outcomes in one-year poststroke in Benin, a lower middle-income country. METHODS A case-control study was carried out in northern Benin. Twenty-one participants with chronic strokes were matched to 42 controls according to sex and age. PA patterns and associated energy expenditure (EE) were assessed with a BodyMedia's senseWear armband. CF was evaluated with the Physical Working Capacity at 75% of the predicted maximal heart rate index. The functional outcomes were evaluated using the modified Rankin scale (mRS) and the ACTIVLIM-Stroke scale. RESULTS Both people with stroke and the healthy pairs spent much time in sedentary behavior (median [P25; P75]: 672 [460; 793] min vs 515 [287; 666] min, p = 0.006). Although people with chronic stroke performed fewer steps compared to healthy controls (median: 2767 vs 5524, p = 0.005), results showed that total EE was not statistically significant in either group (median: 7166 Kcal vs 8245 Kcal, p = 0.07). In addition, the mRS score (r = 0.47, p = 0.033) and the ACTIVLIM-Stroke measure (r = 0.52, p = 0.016) were moderately associated with the CF index of people with chronic stroke. CONCLUSION The study showed clear trends for lower levels of PA in both people with chronic stroke and health controls. A correlation exists between CF, disability, and functional outcomes among stroke patients.
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Affiliation(s)
- Oyéné Kossi
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou, Benin
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Bruno Bonnechère
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Mendinatou Agbetou
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin
- Department of Neurology, Faculty of Medicine, University of Parakou, Parakou, Benin
| | - Ruth Somasse
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin
| | - Athanase Hokpo
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin
| | | | - Thierry Adoukonou
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou, Benin
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin
- Department of Neurology, Faculty of Medicine, University of Parakou, Parakou, Benin
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Ebner-Karestinos D, Gathy E, Carton de Tournai A, Herman E, Araneda R, Dricot L, Macq B, Vandermeeren Y, Bleyenheuft Y. Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in adults with chronic stroke: protocol of a randomised controlled trial. BMJ Open 2023; 13:e070642. [PMID: 37055214 PMCID: PMC10106060 DOI: 10.1136/bmjopen-2022-070642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION Stroke causes multiple deficits including motor, sensitive and cognitive impairments, affecting also individual's social participation and independence in activities of daily living (ADL) impacting their quality of life. It has been widely recommended to use goal-oriented interventions with a high amount of task-specific repetitions. These interventions are generally focused only on the upper or lower extremities separately, despite the impairments are observed at the whole-body level and ADL are both frequently bimanual and may require moving around. This highlights the need for interventions targeting both upper and lower extremities. This protocol presents the first adaptation of Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) for adults with acquired hemiparesis. METHODS AND ANALYSIS This randomised controlled trial will include 48 adults with chronic stroke, aged ≥40 years. This study will compare the effect of 50 hours of HABIT-ILE against usual motor activity and regular rehabilitation. HABIT-ILE will be provided in a 2-week, adult's day-camp setting, promoting functional tasks and structured activities. These tasks will continuously progress by increasing their difficulty. Assessed at baseline, 3 weeks after and at 3 months, the primary outcome will be the adults-assisting-hand-assessment stroke; secondary outcomes include behavioural assessments for hand strength and dexterity, a motor learning robotic medical device for quality of bimanual motor control, walking endurance, questionnaires of ADL, stroke impact on participation and self-determined patient-relevant goals, besides neuroimaging measures. ETHICS AND DISSEMINATION This study has full ethical approval from the Comité d'éthique Hospitalo-Facultaire/Université catholique de Louvain, Brussels (reference number: 2013/01MAR/069) and the local medical Ethical Committee of the CHU UCL Namur-site Godinne. Recommendations of the ethical board and the Belgian law of 7 May 2004, concerning human experiments will be followed. Participants will sign a written informed consent ahead of participation. Findings will be published in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT04664673.
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Affiliation(s)
- Daniela Ebner-Karestinos
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andrés Bello, Santiago, Chile
| | - Estelle Gathy
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | | | - Enimie Herman
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andrés Bello, Santiago, Chile
| | - Laurence Dricot
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Neuroimaging platform (NIMA), Université catholique de Louvain, Brussels, Belgium
| | - Benoît Macq
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTM), Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Yves Vandermeeren
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Neurology Department, Stroke Unit/NeuroModulation Unit (NeMU), Université catholique de Louvain, Yvoir, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Nindorera F, Nduwimana I, Sinzakaraye A, Havyarimana E, Bleyenheuft Y, Thonnard JL, Kossi O. Effect of mixed and collective physical activity in chronic stroke rehabilitation: A randomized cross-over trial in low-income settings. Ann Phys Rehabil Med 2022; 66:101704. [PMID: 36115574 DOI: 10.1016/j.rehab.2022.101704] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The prevalence of physical inactivity after stroke is high and exercise training improves many outcomes. However, access to community training protocols is limited, especially in low-income settings. OBJECTIVE To investigate the feasibility and efficacy of a new intervention: Circuit walking, balance, cycling and strength training (CBCS) on activity of daily living (ADL) limitations, motor performance, and social participation restrictions in people after stroke. METHODS Forty-six community-dwelling individuals with chronic stroke who were no longer in conventional rehabilitation were randomized into an immediate CBCS group (IG; initially received CBCS training for 12 weeks in phase 1), and a delayed CBCS group (DG) that first participated in sociocultural activities for 12 weeks. In phase 2, participants crossed over so that the DG underwent CBCS and the IG performed sociocultural activities. The primary outcome was ADL limitations measured with the ACTIVLIM-Stroke scale. Secondary outcomes included motor performance (balance: Berg Balance Scale [BBS], global impairment: Stroke Impairment Assessment Set [SIAS] and mobility: 6-minute and 10-metre walk tests [6MWT and 10mWT] and psychosocial health [depression and participation]). Additional outcomes included feasibility (retention, adherence) and safety. RESULTS ADL capacity significantly improved pre to post CBCS training (ACTIVLIM-stroke, +3,4 logits, p < 0.001; effect size [ES] 0.87), balance (BBS, +21 points, p < 0.001; ES 0.9), impairments (SIAS, +11 points, p < 0.001; ES 0.9), and mobility (+145 m for 6MWT and +0.37 m/s for 10mWT; p < 0.001; ES 0.7 and 0.5 respectively). Similar improvements in psychosocial health occurred in both groups. Adherence and retention rates were 95% and 100%, respectively. CONCLUSION CBCS was feasible, safe and improved functional independence and motor abilities in individuals in the chronic stage of stroke. Participation in CBCS improved depression and social participation similarly to participation in sociocultural activities. The benefits persisted for at least 3 months after intervention completion. PROTOCOL REGISTRATION NUMBER PACTR202001714888482.
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Affiliation(s)
- Félix Nindorera
- MSL-IN Laboratory, Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium; National Center of Reference in Physical Therapy and Medical Rehabilitation, University Hospital Roi-Khaled, Bujumbura, Burundi.
| | - Ildephonse Nduwimana
- MSL-IN Laboratory, Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium; National Center of Reference in Physical Therapy and Medical Rehabilitation, University Hospital Roi-Khaled, Bujumbura, Burundi
| | - Alexis Sinzakaraye
- National Center of Reference in Physical Therapy and Medical Rehabilitation, University Hospital Roi-Khaled, Bujumbura, Burundi
| | - Eric Havyarimana
- National Center of Reference in Physical Therapy and Medical Rehabilitation, University Hospital Roi-Khaled, Bujumbura, Burundi
| | - Yannick Bleyenheuft
- MSL-IN Laboratory, Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium
| | - Jean-Louis Thonnard
- MSL-IN Laboratory, Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium
| | - Oyéné Kossi
- Service de Kinésithérapie et d'Appareillage Orthopédique, Hôpital Universitaire de Parakou, Parakou, Benin; ENATSE, Ecole Nationale de Santé Publique et d'Epidémiologie, Université de Parakou, Parakou, Benin
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Pagola I, Torné L, Jericó I, Ibáñez B. Transcultural adaptation and validation of the Spanish-language version of ACTIVLIM in adults with inherited myopathies using the Rasch model. NEUROLOGÍA (ENGLISH EDITION) 2021; 36:514-524. [DOI: 10.1016/j.nrleng.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/29/2018] [Indexed: 10/24/2022] Open
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Pagola I, Torné L, Jericó I, Ibáñez B. ACTIVLIM: adaptación transcultural al castellano y validación en adultos con miopatías hereditarias utilizando el modelo Rasch. Neurologia 2021. [DOI: 10.1016/j.nrl.2018.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tracking Changes in Participation With Participation Measurement Scale in Community-Dwelling Stroke Survivors in Africa. Arch Phys Med Rehabil 2018; 99:2238-2243. [DOI: 10.1016/j.apmr.2018.03.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 11/17/2022]
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Batcho CS, Van den Bergh PY, Van Damme P, Roy AJ, Thonnard JL, Penta M. How robust is ACTIVLIM for the follow-up of activity limitations in patients with neuromuscular diseases? Neuromuscul Disord 2016; 26:211-20. [DOI: 10.1016/j.nmd.2015.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/13/2015] [Accepted: 12/10/2015] [Indexed: 10/22/2022]
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