Physical activity dimensions after stroke: patterns and relation with lower limb motor function.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Stroke survivors often experience reduced physical functioning and low physical activity levels.
• Physical activity is a complex, multidimensional construct crucial for recovery.
• Understanding multidimensional physical activity patterns can inform targeted rehabilitation strategies.

Purpose of the Study:

• To investigate the longitudinal development of multidimensional physical activity during the subacute phase after stroke.
• To examine the correlation between changes in physical activity and lower limb motor function recovery.

Main Methods:

• A longitudinal cohort study involving 39 stroke survivors recruited during inpatient rehabilitation.
• Physical activity was measured using an accelerometer (Activ8) assessing intensity, frequency, distribution, and duration.
• Motor function was assessed using the Fugl-Meyer Lower Extremity Assessment (FMA-LE) at 3, 12, and 26 weeks post-stroke.
• Generalized estimating equations (GEE) were employed to analyze changes over time and their relationship with motor recovery.

Main Results:

• Physical activity intensity and duration significantly increased between 3 and 12 weeks post-stroke (p=0.007 and p=0.012, respectively).
• No significant overall effect of motor function on physical activity was observed across the time points (p>0.020).
• A significant interaction effect between time and motor function was found (p<0.001).

Conclusions:

• Physical activity recovery patterns vary across different dimensions (intensity, duration, frequency, distribution).
• Increases in physical activity intensity and duration were most prominent between 3 and 12 weeks post-stroke.
• The lack of strong association with motor recovery and high inter-individual variability underscore the need for personalized rehabilitation approaches.