Movement behavior patterns in people with first-ever stroke

Abstract

Background and Purpose-Movement behaviors, that is, both physical activity and sedentary behavior, are independentlyassociated with health risks. Although both behaviors have been investigated separately in people after stroke, littleis known about the combined movement behavior patterns, differences in these patterns between individuals, or thefactors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behaviorpatterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with theidentified patterns.Methods-Cross-sectional design using data from 190 people with first-ever stroke discharged to the home setting.Movement, behavior was measured over 2 weeks using an accelerometer. Ten movement behavior outcomes werecalculated and compressed using principal component analysis. Movement behavior patterns were identified using ak-means clustering algorithm. Demographics, stroke, care, physical functioning, and psychological, cognitive and socialfactors were obtained. Differences between and factors associated with the patterns were investigated.Results-On average, the accelerometer was worn for 13.7 hours per day. The average movement behavior of the participantsshowed 9.3 sedentary hours, 3.8 hours of light physical activity, and 0.6 hours of moderate-vigorous physical activity.Three patterns and associated factors were identified: (1) sedentary exercisers (22.6%), with a relatively low age, fewpack-years, light drinking, and high levels of physical functioning; (2) sedentary movers (45.8%), with less severe strokesymptoms, low physical functioning and high levels of self-efficacy; and (3) sedentary prolongers (31.6%), with moresevere stroke symptoms, more pack-years, and low levels of self-efficacy.Conclusions-The majority of people with stroke are inactive and sedentary. Three different movement behavior patternswere identified: sedentary exercisers, sedentary movers, and sedentary prolongers. The identified movement behaviorpatterns confirm the hypothesis that an individually tailored approach might be warranted with movement behaviorcoaching by healthcare professionals.