Stroke is the leading cause of disability in Spain. Additionally, it is the secondleading cause of death in women and the third in both sexes. Regular physical activity(PA) helps prevent and manage stroke. It also helps with hypertension, maintains ahealthy body weight, and improves mental health, quality of life, and well-being. PAplays a prominent role in inpatient care after stroke. However, stroke survivors becomemore sedentary when discharged from the hospital. They have muscle weakness, reducedbalance, and fatigue. Consequently, PA levels of community-dwelling post-strokeindividuals remain lower than their age-matched counterparts. Continued PA can help thispopulation maintain and improve physical function, and reduce long-term functionallimitations, and mortality risk.
Previous studies that performed a comparative analysis of physical activity between
individuals with and without stroke have consistently reported that stroke survivors tend
to spend less time in moderate to vigorous physical activity The 2021 AHA guideline
recommends smaller sessions of PA, with suggestions such as 10 minutes of moderate
activity, 4 times a week, or 20 minutes of vigorous activity twice a week. This contrasts
the weekly physical activity recommendations in 2011 (30 minutes of moderate to vigorous,
1 to 3 times) and 2014 (40 minutes of moderate to vigorous, 3 to 4 times). We hypothesise
that older stroke survivors are physically active more frequently but for smaller
durations than younger stroke survivors who are physically active for longer durations
but less regularly. Understanding these subtle changes will not only help to tailor
physical activity interventions based on specific recommendations but also help design
future recommendations.
Moderate-to-vigorous PA could be an adequate approach for stroke survivors as it requires
less time to achieve the same benefits as light PA. More concretely, a new concept called
moderate-to-vigorous intermittent lifestyle physical activity (MV-ILPA) has recently
emerged for adults who do not habitually exercise in their leisure time. MV-ILPA refers
to brief and sporadic bouts of moderate-vigorous intensity PA performed as part of the
activities of daily living, such as bursts of very fast walking, sitting and standing up
from a chair, or stair climbing. MV-ILPA is associated with a substantially lower risk of
all-cause cardiovascular disease and cancer mortality. However, there is no evidence to
directly support the potential benefits of MV-ILPA in the elderly post-stroke patients.
Other: Moderate-vigorous physical activity
The experimental group will receive usual care plus the MV-ILPA and education program.
First, a physiotherapist will conduct a face-to-face session with the patients detailing
the health benefits of moderate to vigorous PA and the negative effects of not including
it in their daily lives. Patients will receive a booklet with all the key information.
Secondly, participants will take the MV-ILPA program. This program consists of completing
4 length-standardised moderate-to-vigorous intense bouts per day (3 minutes each) of
activities of daily living (sit-to-stand, going up/down stairs, walking fast indoors, and
walking up small slopes) every day for 12 weeks. Once per week for 12 weeks, a
physiotherapist will go to the patient's home for a face-to-face session or
videoconference. This physiotherapist will foster participants' independence and
self-management. The PA intensity will be increased weekly by increasing the execution
speed and including weights.
Other Name: Moderate-vigorous exercise
Inclusion Criteria:
- adults aged ≥57 in the late subacute phase post-stroke.
- who live in the community
- whose clinician confirmed a diagnosis of stroke (ischaemic/haemorrhagic)
- discharged from hospital inpatient regimen
- with independent mobility skills (Barthel Index ≥ 40 points).
Exclusion Criteria:
• other neurological diseases (e.g. Parkinson disease) or severe lower limb injuries.
Not Provided
Marcio Vinicius Fagundes Donadio, PhD
+34935042000
mdonadio@uic.es
David Blanco de Tena-Dávila, PhD
+34935042000
dblanco@uic.es
Rosa Cabanas-Valdés, PhD, Principal Investigator
Universitat Internacional de Catalunya