QUANTIFICATION OF PRE- AND POST- DISCHARGE PHYSICAL ACTIVITY AND HEALTH PROFILE IN PATIENTS WITH LACUNAR STROKE

Steen Krawcyk R.^1,2, Vinther A.¹, Caesar Petersen N.³, Faber J.⁴, Kruuse C.²

¹Herlev Gentofte University Hospital, Department of Rehabilitation, Copenhagen, Denmark, ²Herlev Gentofte University Hospital, Department of Neurology, Neurovascular Research Unit, Copenhagen, Denmark, ³University of Copenhagen, Center for Basic and Translational Neuroscience, Copenhagen, Denmark, ⁴Herlev Gentofte University Hospital, Department of Internal Medicine, Division of Endocrinology, Copenhagen, Denmark

Background: Lacunar stroke is characterized by mild symptoms, quick remission, and thus early discharge. Though quick remission is seen, patients show increased risk of recurrent stroke, cognitive deficits or vascular dementia over time. Increased physical exercise post stroke may improve cardiovascular fitness and endothelial function, thus slowing progression of vascular diseases, potentially preventing recurrent stroke. We hypothesized that patients with lacunar stroke are inactive both before and continue to be so after their stroke. The continued inactivity could be caused by quick remission of symptoms thus reducing the motivations for lifestyle changes or that patients refrain from activity of fear that physical activity may increase risk of recurrent or worsening of symptoms. Such may sustain or increase their risk of a recurrent stroke.

Purpose: To investigate the level of physical activity before and immediately after hospital discharge in patients with lacunar stroke.

Methods: The study is a cross-sectional study including 100 patients with lacunar stroke. We examine the level of physical activity and the patients´ health profile measured by accelerometer and a self-reported outcome measure. Data is collected as part of a larger study – a randomized controlled trial investigating the effect of aerobic exercise. Patients are recruited from the stroke unit at Herlev Gentofte University hospital, Copenhagen. Inclusion criteria are: 1) > 18 years old 2) clinical symptoms of a lacunar stroke, acute or older lacunar stroke verified by CT or MRI scan and 3) ability to read and speak Danish. During hospitalization the patients´ aerobic fitness level is measured with a submaximal exercise test carried out on a stationary bicycle (Graded Cycling Test with Talk Test). Further, pre-stroke level of physical exercise is assessed by a self-reported questionnaire (Physical Activity Scale - PAS). As the patients are discharged they are equipped with an accelerometer (AX3, Axivity) placed on their right thigh for eight days recording how physically active they are in their daily living. To quantify the patients´ health status the following measures are recorded: Endothelial response by EndoPAT2000, Stress level measured by Ullmeter, Quality of Life measured by WHO-5 well-being Index (WHO-5), cognitive function measured by Montreal Cognitive Assessment (MOCA), fatigue measured by Multidimensional Fatigue Inventory (MFI-20), depression measured by Major Depression inventory (MDI), blood pressure and blood samples.

Results: The study is ongoing.

Conclusion(s): Complete sets of physical activity data from patients with lacunar stroke after hospitalization is to be presented at the congress. This will include a health description profile.

Implications: This study contributes to a strengthening of our understanding of the relationship between physical activity and the endothelial response to physical activity. Further it describes the health profile of this subgroup of stroke patients and it tests our hypothesis that patients with lacunar stroke are inactive both before and after hospital discharge.

Funding acknowledgements: · The Association of Danish Physiotherapists
· Toyota-Fonden, Denmark
· ProTerapi A/S
· Lions Clubs International
· Axel Muusfeldts Fond

Topic: Neurology: stroke

Ethics approval: The study has been approved by The Research Ethics Committee in the Capital Region of Denmark (H-15012371).

All authors, affiliations and abstracts have been published as submitted.