Improving physical movement during stroke rehabilitation: investigating associations between sleep measured by wearable actigraphy technology, fatigue, and key biomarkers.

The study included only 18 participants, and the number screened for eligibility was not recorded, so the findings may not apply to other stroke inpatients. It was cross-sectional and measured sleep and movement at one time point, so it cannot show that sleep caused fatigue or motor changes, or how sleep varied across nights. The small sample prevented adjustment for participant characteristics such as stroke severity, so other factors may explain the links. No participants had severe stroke, and most had moderate stroke, so it says little about people with severe stroke. Nursing progress notes were available for only 8 participants, while actigraphy and patient reports were available for 18.

Funding was provided by the National Health and Medical Research Council and the National Heart Foundation of Australia. The supplied text does not give a separate competing-interests declaration.

Do not tell patients that poor sleep caused their affected-side weakness. The study measured sleep and movement at one time point, found no sleep link for the affected side, and linked sleep only to non-affected hand performance. With 18 participants and no adjustment for other factors, these links cannot be treated as proof.