TY - JOUR
T1 - Trajectories of physical activity after ischaemic stroke
T2 - Exploring prediction of change
AU - Damsbo, Andreas Gammelgaard
AU - Blauenfeldt, Rolf Ankerlund
AU - Andersen, Grethe
AU - Johnsen, Søren P.
AU - Mortensen, Janne Kaergaard
N1 - Publisher Copyright:
© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2025/1
Y1 - 2025/1
N2 - Background and purpose: Physical activity (PA) is associated with lower risk of stroke and better functional outcome. However, low levels of PA after stroke are prevalent. The aim was to identify predictors of PA change after first-time ischaemic stroke and to develop prediction models to predict change in PA. Methods: Pre-stroke and 6 months post-stroke PA were quantified with the Physical Activity Scale for the Elderly (PASE). Considered predictors were clinical data and demographics including data on socioeconomic status (SES). PASE change was analysed using mixed models of repeated measures. Elastic net regression models were used to predict decrease from higher PASE quartile to the lowest and increase from lowest to higher. Results: A total of 523 first-time ischaemic stroke patients were included. Median (interquartile range, IQR) age was 69 years (IQR 59, 77), 181 (35%) were female and median National Institutes of Health Stroke Scale score was 3 (IQR 2, 5). Overall PASE score did not change, but 20% of patients decreased to the lowest PASE quartile whereas 48% from the lowest quartile increased to a higher. Prediction performance measured by area under the receiver operating curve was 0.679 for PA decrease and 0.619 for increase. SES factors were the most consistent predictors. Conclusions: Half of the least active patients increased PA level after stroke whereas a fifth decreased with SES being the most consistent predictor. Despite comprehensive data, the prediction models only performed modestly. Efforts to optimize PA should include all stroke survivors to increase PA for least active patients and to prevent PA decrease.
AB - Background and purpose: Physical activity (PA) is associated with lower risk of stroke and better functional outcome. However, low levels of PA after stroke are prevalent. The aim was to identify predictors of PA change after first-time ischaemic stroke and to develop prediction models to predict change in PA. Methods: Pre-stroke and 6 months post-stroke PA were quantified with the Physical Activity Scale for the Elderly (PASE). Considered predictors were clinical data and demographics including data on socioeconomic status (SES). PASE change was analysed using mixed models of repeated measures. Elastic net regression models were used to predict decrease from higher PASE quartile to the lowest and increase from lowest to higher. Results: A total of 523 first-time ischaemic stroke patients were included. Median (interquartile range, IQR) age was 69 years (IQR 59, 77), 181 (35%) were female and median National Institutes of Health Stroke Scale score was 3 (IQR 2, 5). Overall PASE score did not change, but 20% of patients decreased to the lowest PASE quartile whereas 48% from the lowest quartile increased to a higher. Prediction performance measured by area under the receiver operating curve was 0.679 for PA decrease and 0.619 for increase. SES factors were the most consistent predictors. Conclusions: Half of the least active patients increased PA level after stroke whereas a fifth decreased with SES being the most consistent predictor. Despite comprehensive data, the prediction models only performed modestly. Efforts to optimize PA should include all stroke survivors to increase PA for least active patients and to prevent PA decrease.
KW - ischaemic stroke
KW - physical activity
KW - prediction model
KW - socioeconomic factors
UR - http://www.scopus.com/inward/record.url?scp=85209785361&partnerID=8YFLogxK
U2 - 10.1111/ene.16545
DO - 10.1111/ene.16545
M3 - Journal article
C2 - 39564872
AN - SCOPUS:85209785361
SN - 1351-5101
VL - 32
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 1
M1 - e16545
ER -