Compositional associations between movement-related behaviours and functional outcomes post-stroke

Disabil Rehabil. 2024 Feb 19:1-7. doi: 10.1080/09638288.2024.2317995. Online ahead of print.

Abstract

Purpose: To examine the associations between the composition of movement-related behaviours (sedentary behaviour, sleep, standing, and stepping) and functional outcomes post-stroke.

Methods: This study included 34 adults with stroke (mean age: 64.6 ± 12.5 years; time since stroke: 3.5 ± 1.1 months) who underwent an 8-week sedentary behaviour intervention. Functional outcomes were assessed using the timed up and go (TUG) and gait speed tests. Compositional data analysis was used to investigate the relationships between movement-related behaviours and functional outcomes.

Results: The baseline composition of movement-related behaviours showed significant associations with changes in TUG (F = 4.28, p = 0.01) and gait speed (F = 4.63, p = 0.01) after the 8-week reducing sedentary behaviour intervention. Reallocating ≥ 30 min/day to stepping, while proportionally decreasing other movement-related behaviours, was associated with a significant change in TUG. Similarly, a relative reallocation of ≥ 40 min/day to stepping was associated with a clinically meaningful change in gait speed.

Conclusions: This study highlights the importance of considering movement-related behaviours in relation to functional outcomes post-stroke. Reallocating at least 30 min per day to stepping, relative to a reduction in other movement-related behaviours, is associated with significant and meaningful change in functional outcomes.

Keywords: CoDA; Stroke; TUG; function; gait speed; movement-behaviour; whole-day.

Plain language summary

Reallocating at least 30 minutes/day to stepping, relative to a decrease in other movement-related behaviours, is associated with a positive change in functional mobility after an 8-week post-stroke sedentary behaviour intervention.Relative to a decrease in other movement-behaviours, reallocating ≥ 40 minutes/day to stepping is associated with a meaningful change in gait speed.Reallocating time to standing or sleep at the expense of other movement behaviours is not associated with better functional mobility or gait speed.Finding the optimal balance in movement-related behaviours that favours more stepping may lead to improvements in both functional mobility and gait speed.