Rocha SMdA1, Oliveira JR1, Wetzel T2, Lopes A2, Oliveira TDP3, Pimentel Piemonte ME1,2
1University Hospital of University of Sao Paulo, Physical Therapy, Sao Paulo, Brazil, 2University of Sao Paulo, Physical Therapy, Sao Paulo, Brazil, 3University of Sao Paulo, Sao Paulo, Brazil
Background: The decreased level of physical activity (PA) is a global health problem. Particularly for people with some level of disability as people with chronic sequels of Stroke. Considering that the prevalence of comorbidades as systemic arterial hypertension, cardiac dysfunctions and diabetes mellitus is very high in this population, the decreased level of physical activity is particularly worrying. The motor disability has been considered as the main obstacle for adherence to physical activity, however non-motor sequels may work as barrier too.
Purpose: To investigate the correlation among adherence to physical activity and motor and non-motor disfunction in people with chronic sequels of Stroke.
Methods: One hundred three people with stroke, mean time pos-stroke of the 3.63 (SD= 1.44), 41 left sided stroke, with mean age of 64.14 (SD=13.7), 53 men, with 7.01 (SD=4.25) years of schooling took part in this study. The participants were interviewed by phone by two physiotherapists specialized in neurorehabilitation. In case of cognitive or communication impairment which impaired the interview, a closest relative was invited to answer the questions. The primary outcomes were
(1) Functional Independence Measure (FIM) to assess the level of functionality in the motor domains as eating, grooming, bathing, dressing- upper body, dressing-lower body, toileting, bladder management, bowel management, transfers - bed/chair/wheelchair, transfers - toilet, transfers - bath/shower, walk/wheelchair, stairs, and cognitive domains as comprehension, expression, social interaction, problem solving and memory,
(2) structured questionnaire about adherence to PA and comorbidades as smoking, alcoholism, depression, heart disease, pulmonary disease, systemic arterial hypertension, rheumatic diseases and presence of pain. Each item in FIM is scored on a 7 point ordinal scale, ranging from a score of 1 to a score of 7. The higher the score, the more independent the participant is in performing the task associated with that item. The total score for the FIM motor subscale is a value between 13 and 91 while for FIM cognition subscale is a value between 5 and 35.
Results: The proper statistical analysis showed that only 16% of PwS performed a regular physical activity. The modality more frequent was walking (73.4%), with the twice a week frequency (53.3%). The mean scores were 76.05 (SD=18.2) and 28.97 (SD= 7.2) for FIM motor subscale and cognition subscale respectively. Surprisedly, there was no significative correlation between adherence to PA and scores in MIF motor subscale or between adherence to PA and comorbidities. However, there were a significant correlation between adherence to PA and comprehension (p=.04), expression (p=.01), social interaction (.01), problem solving (p=.03) according to FIM cognition subscale.
Conclusion(s): The level of adherence to PA in PwS in very low and, on the contrary as expected, correlated only with cognitive dysfunctions.
Implications: The interdisciplinary care to improve cognitive function of PwS in crucial to decrease the barriers to adherence to PA and, consequently, to improve the health conditions of them, decreasing the risk of health problems associate to sedentarism.
Keywords: FIM, Physical activity, functionality
Funding acknowledgements: Fundação Faculdade de Medicina
Purpose: To investigate the correlation among adherence to physical activity and motor and non-motor disfunction in people with chronic sequels of Stroke.
Methods: One hundred three people with stroke, mean time pos-stroke of the 3.63 (SD= 1.44), 41 left sided stroke, with mean age of 64.14 (SD=13.7), 53 men, with 7.01 (SD=4.25) years of schooling took part in this study. The participants were interviewed by phone by two physiotherapists specialized in neurorehabilitation. In case of cognitive or communication impairment which impaired the interview, a closest relative was invited to answer the questions. The primary outcomes were
(1) Functional Independence Measure (FIM) to assess the level of functionality in the motor domains as eating, grooming, bathing, dressing- upper body, dressing-lower body, toileting, bladder management, bowel management, transfers - bed/chair/wheelchair, transfers - toilet, transfers - bath/shower, walk/wheelchair, stairs, and cognitive domains as comprehension, expression, social interaction, problem solving and memory,
(2) structured questionnaire about adherence to PA and comorbidades as smoking, alcoholism, depression, heart disease, pulmonary disease, systemic arterial hypertension, rheumatic diseases and presence of pain. Each item in FIM is scored on a 7 point ordinal scale, ranging from a score of 1 to a score of 7. The higher the score, the more independent the participant is in performing the task associated with that item. The total score for the FIM motor subscale is a value between 13 and 91 while for FIM cognition subscale is a value between 5 and 35.
Results: The proper statistical analysis showed that only 16% of PwS performed a regular physical activity. The modality more frequent was walking (73.4%), with the twice a week frequency (53.3%). The mean scores were 76.05 (SD=18.2) and 28.97 (SD= 7.2) for FIM motor subscale and cognition subscale respectively. Surprisedly, there was no significative correlation between adherence to PA and scores in MIF motor subscale or between adherence to PA and comorbidities. However, there were a significant correlation between adherence to PA and comprehension (p=.04), expression (p=.01), social interaction (.01), problem solving (p=.03) according to FIM cognition subscale.
Conclusion(s): The level of adherence to PA in PwS in very low and, on the contrary as expected, correlated only with cognitive dysfunctions.
Implications: The interdisciplinary care to improve cognitive function of PwS in crucial to decrease the barriers to adherence to PA and, consequently, to improve the health conditions of them, decreasing the risk of health problems associate to sedentarism.
Keywords: FIM, Physical activity, functionality
Funding acknowledgements: Fundação Faculdade de Medicina
Topic: Neurology: stroke; Disability & rehabilitation; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: University Hospital
Ethics committee: Ethical commitee of HU
Ethics number: 65695
All authors, affiliations and abstracts have been published as submitted.
