Upright activity within the first week after stroke is associated with better functional outcome and health-related quality of life: A Norwegian multi-site study

J Rehabil Med. 2016 Mar;48(3):280-6. doi: 10.2340/16501977-2051.


Objective: To assess the amount of early upright activity of patients managed in Norwegian stroke units and its association with functional outcome and health-related quality of life 3 months later.

Design: A prospective observational multi-centre study.

Subjects: A total of 390 acute stroke patients, mean age 76.8 years, 48.1% men, less than 14 days post-stroke, recruited from 11 Norwegian stroke units.

Methods: Time spent in different activity categories (in bed, sitting out of bed, upright) was observed with a standard method. Outcome was assessed by modified Rankin Scale (mRS), and health-related quality of life by EuroQol-5 Dimension 5 level (EQ-5D-5L) 3 months later. Ordinal logistic and linear regression analyses were used to examine the association between activity categories and mRS and EQ-5D-5L, respectively. Age, National Institute of Health Stroke Scale (NIHSS) score, premorbid mRS, sex, and hospital-site were added as covariates.

Results: The odds ratio (OR) (95% confidence interval (CI)) for poorer functional outcome (higher mRS) decreased as time spent in upright activities increased (OR 0.97 (95% CI 0.94-1.00)). There was also a significant positive association between time in upright activity and higher EQ-5D-5L, Beta 0.184 (95% CI 0.001- 0.008) 3 months later.

Conclusion: This study confirms the beneficial effect of upright activity applied during hospital stay in Norwegian stroke units.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Norway
  • Odds Ratio
  • Outcome Assessment, Health Care / methods
  • Posture
  • Prospective Studies
  • Psychometrics
  • Quality of Life*
  • Recovery of Function
  • Stroke / physiopathology
  • Stroke Rehabilitation*