A 2-Year Longitudinal Study of Physical Activity and Cardiovascular Risk in Survivors of Stroke

Natalie A Fini; Julie Bernhardt; Leonid Churilov; Rebecca Clark; Anne E Holland

doi:10.1093/ptj/pzaa205

A 2-Year Longitudinal Study of Physical Activity and Cardiovascular Risk in Survivors of Stroke

Phys Ther. 2021 Feb 4;101(2):pzaa205. doi: 10.1093/ptj/pzaa205.

Authors

Natalie A Fini^{1

2

3}, Julie Bernhardt⁴, Leonid Churilov⁵, Rebecca Clark¹, Anne E Holland^{1

2

6}

Affiliations

¹ Physiotherapy Department, Alfred Health, Melbourne, Australia.
² Physiotherapy Department, La Trobe University, Melbourne, Australia.
³ Physiotherapy Department, The University of Melbourne, Parkville, Australia.
⁴ Stroke Division, Florey Institute of Neurosciences and Mental Health, Heidelberg, Australia.
⁵ Melbourne Medical School, The University of Melbourne, Parkville, Australia.
⁶ Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.

PMID: 33305804
DOI: 10.1093/ptj/pzaa205

Abstract

Objective: The purpose of this study was to explore associations between physical activity, cardiovascular risk factors, mobility, mood, fatigue, and cognition over 2 years following stroke rehabilitation discharge.

Methods: In this longitudinal observational study, survivors of first-ever stroke were evaluated at rehabilitation discharge and 6, 12, and 24 months later. Moderate to vigorous physical activity (MVPA) duration (minutes/day) assessed with an electronic monitor was the primary outcome. Further outcomes included step count, the number and duration of MVPA and sedentary bouts, cardiovascular risk factors (eg, blood pressure, fasting lipid profile, body mass index [BMI]), gait speed and endurance, mood, fatigue, and cognition. Associations between physical activity and cardiovascular risk factors over time were assessed with random-effects regression modeling. Associations between baseline characteristics and physical activity at 2 years were explored using regression modeling.

Results: Seventy-nine participants (68.4% men) with a mean age of 65 years (SD = 14) and a median gait speed of 1.2 m/s (interquartile range = 0.8 to 1.4) were included at baseline. Associations were found between higher physical activity (MVPA duration, number and duration of MVPA bouts) and lower BMI. Better gait speed, endurance, and cognition at baseline were associated with higher MVPA and step count at 2 years.

Conclusions: Duration and bouts of MVPA are associated with BMI. Increasing MVPA and bouts of MVPA may be a valuable treatment goal to reduce cardiovascular risk in survivors of stroke.

Impact: This 2-year study found that MVPA is associated with important cardiovascular risk factors in people who have survived stroke. Understanding these associations could be useful for developing effective treatments to prevent recurrent stroke.

Lay summary: Performing MVPA and accumulating in bouts of at least 10 minutes might be challenging, but it could be an important component of treatments to reduce cardiovascular risk after stroke.

Keywords: Body Mass Index; Cardiovascular Risk; Longitudinal; Physical Activity; Stroke.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Affect / physiology
Aged
Body Mass Index
Cognition / physiology
Exercise / physiology*
Fatigue / physiopathology
Female
Heart Disease Risk Factors*
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Stroke Rehabilitation*
Survivors
Walk Test