The Longitudinal Course of Physical Activity Behavior Poststroke and Its Variation Across Subgroups: The Norwegian Cognitive Impairment After Stroke Study.
Geske Luzum, Heather Allore, Ling Han and 5 others
PMID 40360170WHAT IT FOUND
Stroke survivors' physical activity declined steadily over three years.
A quarter of participants remained in the least active group, with only the most active group meeting step recommendations. No subgroup increased activity over time, suggesting early intervention is critical to prevent long-term decline.
Key findings
01Daily upright time and step counts declined linearly from 3 to 36 months poststroke, with no evidence of increasing activity in any subgroup.
02Four distinct activity trajectories were identified, but the least active group (25.6%) showed marked declines in all dimensions and had the highest mortality.
03Only the most active group (21.2%) met the recommended daily step count threshold of 6,500 to 8,500 steps, leaving four out of five participants below this target.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study population had primarily mild strokes (85.2% NIHSS 0-5) and high function (91.8% mRS ≤2 at 3 months), so findings may not apply to those with severe disability. Accelerometers cannot capture non-translatory activities (e.g., upper body movement) or the context of the activity. The step-rate threshold used to define moderate activity may have overestimated moderate physical activity levels. Attrition increased over time, with only 153 participants providing data at 36 months. The observational design cannot rule out unmeasured confounding factors affecting activity levels.
Declared interests
The study was funded by the Norwegian Health Association, NTNU, and the US National Institute on Aging. The funders had no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not interpret the decline in activity as inevitable or uniform. While the average trajectory was negative, the 'Frequent and High' group maintained significantly higher activity levels, suggesting that individual differences in baseline function and early intervention can influence long-term outcomes.