WHAT FACTORS ARE ASSOCIATED WITH WALKING AND PHYSICAL ACTIVITY OUTCOMES WITHIN FIRST SIX MONTHS AFTER STROKE: A SYSTEMATIC REVIEW

N. Nayak¹, N. Mahendran¹, S. Kuys², S. Brauer¹

¹The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, ²Australian Catholic University, School of Allied Health, Brisbane, Australia

Background: Physical activity is low after stroke. Walking is an evidence based and common approach used to increase physical activity, though is often impaired after stroke. Spontaneous recovery potential is maximal for 1-3 months after stroke as there is high plasticity within this time window, which is vital to influence walking and physical activity after stroke. Optimising walking and physical activity recovery in the first few months after stroke is important. Understanding factors at hospital discharge after stroke associated with walking and physical activity outcomes would help design appropriate interventions.

Purpose: To identify factors at hospital discharge after stroke associated with walking and physical activity outcomes in the first six months after stroke.

Methods: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic searches were conducted in CINAHL, EMBASE, Web of Science, PubMed and Scopus. Studies of adult stroke survivors reporting walking and/or physical activity outcomes, where measures were recorded at hospital discharge and followed up within six months, were included. Two independent reviewers screened full-text articles. Any disagreement was resolved by consensus. Quality of included studies was assessed with the Quality in Prognostic Studies screening tool for prognostic factor studies.

Results: The search strategy yielded 7399 studies, from which sixteen eligible studies were identified. Overall, the identified studies were of high quality. Fourteen studies reported on walking outcomes. Light intensity physical activity, balance and mobility were associated with walking outcomes three months after stroke. Lower limb strength, cognition, and self-efficacy for walking at hospital discharge, were associated with walking outcomes six months after stroke. Two studies reported on physical activity outcomes. No studies reported on physical activity outcomes three months after stroke. Pre-stroke physical activity, cognition, walking speed and endurance were associated with physical activity outcomes six months after stroke.

Conclusions: A range of factors are associated with walking and physical activity outcomes six months after stroke. Most of the studies investigated physical capacity factors such as strength, balance and mobility. Other factors including motivation, goals and self-efficacy levels need to be addressed when targeting walking and physical activity and have not been explored, warranting further investigation.

Funding acknowledgements: -

Keywords:
Stroke
Walking
Physical activity

Topics:
Neurology: stroke
Health promotion & wellbeing/healthy ageing/physical activity
Disability & rehabilitation

Did this work require ethics approval? No

Reason: Systematic review