Prestroke Physical Activity Matters for Functional Limitations: A Longitudinal Case-Control Study of 12,860 Participants.

IF 3.5 4区 医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-10-02 DOI:10.1093/ptj/pzae094
Zachary M van Allen, Dan Orsholits, Matthieu P Boisgontier
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Abstract

Objective: In the chronic phase after a stroke, limitations in basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) initially plateau before steadily increasing. The benefits of prestroke physical activity on these limitations remain unclear. To clarify this relationship, the effect of physical activity on the long-term evolution of functional limitations in a cohort of people with stroke compared to a cohort of matched adults without stroke was examined.

Methods: Longitudinal data from 2143 people with stroke and 10,717 adults without stroke aged 50 years and older were drawn from a prospective cohort study based on the Survey of Health, Ageing and Retirement in Europe (2004-2022; eight data collection waves). Physical activity was assessed in the prestroke wave. Functional limitations were assessed in the poststroke waves. Each person with stroke was matched with five adults without stroke who had similar propensity scores computed on the basis of key covariates, including baseline age, sex, body mass index, limitations in ADLs and IADLs, chronic conditions, and country of residence, before any of the participants from either cohort had experienced a stroke.

Results: Results showed an interaction between stroke status and physical activity on ADL limitations (b = -0.076; 95% CI = -0.142 to -0.011), with the beneficial effect of physical activity being stronger in people with stroke (b = -0.345; 95% CI = -0.438 to -0.252) than in adults without stroke (b = -0.269; 95% CI = -0.269 to -0.241).

Conclusion: The beneficial effect of prestroke physical activity on ADL limitations after stroke is stronger than its effect in matched adults without stroke followed for a similar number of years.

Impact: Physical activity, an intervention within the physical therapist's scope of practice, is effective in reducing the risk of functional dependence after stroke. Moreover, prestroke levels of physical activity can inform the prognosis of functional dependence in people with stroke.

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中风前体育锻炼对功能限制的影响:一项针对 12,860 名参与者的纵向病例对照研究。
目的:在脑卒中后的慢性期,日常生活活动(ADLs)和工具性日常生活活动(IADLs)的限制最初趋于平稳,然后稳步增加。卒中前体育锻炼对这些限制的益处尚不清楚。为了澄清这种关系,我们研究了体育锻炼对中风患者队列中功能限制的长期演变的影响,并将其与匹配的未中风成人队列进行了比较:方法:2143 名中风患者和 10717 名无中风的 50 岁及以上成年人的纵向数据来自一项基于欧洲健康、老龄化和退休调查(2004-2022 年;8 次数据收集波)的前瞻性队列研究。在中风前的波次中对体力活动进行了评估。功能限制在中风后进行评估。每个中风患者与 5 个未中风的成年人进行配对,这些成年人在任何一个队列中的任何参与者发生中风之前,根据主要协变量(包括基线年龄、性别、体重指数、ADLs 和 IADLs 限制、慢性病和居住国)计算出相似的倾向分数:结果表明,中风状态与体育锻炼对 ADL 限制的交互作用(b = -0.076;95% CI = -0.142--0.011),体育锻炼对中风患者的影响(b = -0.345;95% CI = -0.438--0.252)强于对未中风成人的影响(b = -0.269;95% CI = -0.269--0.241):结论:卒中前体育锻炼对卒中后ADL受限的有益影响要强于对匹配的无卒中成人进行类似年限的随访:影响:体育锻炼是理疗师执业范围内的一项干预措施,可有效降低中风后功能依赖的风险。此外,中风前的体力活动水平可以为中风患者功能依赖的预后提供参考。
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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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