Longitudinal relationship between 24-Hour Movement behavior patterns and physical function and quality of life after stroke: a latent transition analysis.

Background: 24-hour movement behavior, including Physical activity (PA), Sedentary behavior (SB), and sleep, is independently associated with health after stroke. Few studies have explored 24-hour movement behavior patterns in stroke survivors and their transitions, as well as the health implications of the transitions. This study aimed to explore the different subgroups and stability of 24-hour movement behavior patterns in people after stroke and the relationship of profile transitions with physical function and health-related quality of life (HRQoL).

Methods: In this study, 131 people with first-ever stroke were investigated at one week (T1), one month (T2), three months (T3), and six months (T4) after discharge. The participants were asked to wear a wristband smartwatch for 7 consecutive days during each pe riod to collect 24-hour exercise data. After each period, their physical function and HRQoL were assessed. Latent profile analysis (LPA) identified typologies of 24-hour movement behaviors, and latent transition analysis (LTA) examined the stability and change in these profiles over time. The relationship of transition types with physical function and HRQoL was analyzed using a generalized linear regression model.

Results: 108 participants were categorized into 3 latent profiles of 24-hour movement behavior: "Active, Non-sedentary, and Short sleep," "Active and Sedentary," and "Inactive and Sedentary." The LTA results indicated that the proportion of participants with the "Active, Non-sedentary, and Short Sleep" profile and "Active and Sedentary" profile staying in the original latent profile was high. However, participants in the "Inactive and Sedentary" profile showed a high probability of transitioning to "Active and Sedentary" profile (T1→T2: 65.2%; T2→T3: 76.3%; T3→T4: 51.7%;T1→T4: 54.2%). Transition types are associated with physical function and HRQoL.

Conclusions: The results demonstrated substantial transitions in 24-hour movement behaviors within 6 months of rehabilitation after discharge, associated with later physical function and HRQoL. Furthermore, the participants' sedentary behavior was highly stable within 24-hour movement behaviors, necessitating prompt diagnosis and intervention.