24h movement behavior trajectory and functional recovery after acute stroke: a prospective study

Area of Science:

• Neurology
• Rehabilitation Medicine
• Public Health

Background:

• 24-hour movement behaviors (physical activity, sedentary behavior, sleep) are crucial for post-stroke health.
• Limited research exists on the dynamic changes (trajectories) of these behaviors and their impact on functional recovery in stroke survivors.

Purpose of the Study:

• To investigate the trajectories of 24-hour movement behavior in stroke survivors.
• To examine the association between these movement behavior trajectories and functional recovery at 12 months post-stroke.

Main Methods:

• A prospective longitudinal study involving 353 stroke survivors from November 2023 to June 2025.
• ActiGraph GT3X+ accelerometers measured movement behaviors at acute, 3-month, and 6-month phases.
• Parallel-Process Latent Class Growth Modeling identified movement behavior trajectories; logistic regression analyzed their effect on functional recovery (modified Rankin Scale).

Main Results:

• Four distinct 24-hour movement behavior trajectories were identified among stroke survivors.
• Compared to a balanced movement group, an imbalanced movement group showed a significantly higher risk of poor prognosis (OR: 5.237).
• A trajectory of prolonged sleep, increased sedentary behavior, and decreased physical activity also indicated a higher risk of poor prognosis (OR: 4.160).

Conclusions:

• Stroke survivors display diverse 24-hour movement behavior patterns following acute stroke.
• Movement behavior trajectories significantly influence functional recovery outcomes.
• Targeted interventions addressing 24-hour movement behavior imbalances are warranted to improve stroke survivor prognosis.