TY - JOUR
T1 - Influence of Interventions on Daily Physical Activity and Sedentary Behavior after Stroke
T2 - A Systematic Review
AU - Kringle, Emily A.
AU - Barone Gibbs, Bethany
AU - Campbell, Grace
AU - McCue, Michael
AU - Terhorst, Lauren
AU - Kersey, Jessica
AU - Skidmore, Elizabeth R.
N1 - Publisher Copyright:
© 2019 American Academy of Physical Medicine and Rehabilitation
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background: Evidence suggests that frequent engagement in daily activities requiring physical activity may influence risk factors for recurrent stroke. The effects of nonpharmacological interventions on daily physical activity levels and sedentary behavior are unclear. Objective: To describe the effects of interventions on levels of daily physical activity and sedentary behavior among people with stroke. Methods: OVID/Medline, CINAHL, PsycINFO, and the Cochrane Database were searched using the following search terms: stroke, rehabilitation, intervention, sedentary, physical activity, lifestyle, self-management, and exercise. Data extraction and risk of bias assessment were conducted by two authors. Results: Thirty-one interventions were identified that included exercise, behavior change techniques, and education components. These components were delivered alone and in varying combinations. At postintervention, between-group effects on change scores (Cohen's d = 0.17–0.75, P <.05) or between-group differences in odds of participating in daily physical activity (odds ratio [OR] = 2.07, P <.05) were detected in six studies, and within-group effects in nine studies (Cohen's d = 0.21–3.97, P <.05). At follow-up, between-group differences in odds of participating in daily physical activity were detected in one study (OR = 2.64, P <.05), and within-group effects in two studies (Cohen's d = 0.25, P <.05). No effects (P <.05) were detected in 17 studies. Conclusion: It may be possible to modify daily physical activity levels and sedentary behavior poststroke; however, there is insufficient evidence to suggest the superiority of a particular intervention approach. Future studies should explore the unique contributions of individual intervention components to guide development of parsimonious multicomponent interventions that are effective for promoting daily physical activity and reducing sedentary behavior among people with stroke. Level of Evidence: I.
AB - Background: Evidence suggests that frequent engagement in daily activities requiring physical activity may influence risk factors for recurrent stroke. The effects of nonpharmacological interventions on daily physical activity levels and sedentary behavior are unclear. Objective: To describe the effects of interventions on levels of daily physical activity and sedentary behavior among people with stroke. Methods: OVID/Medline, CINAHL, PsycINFO, and the Cochrane Database were searched using the following search terms: stroke, rehabilitation, intervention, sedentary, physical activity, lifestyle, self-management, and exercise. Data extraction and risk of bias assessment were conducted by two authors. Results: Thirty-one interventions were identified that included exercise, behavior change techniques, and education components. These components were delivered alone and in varying combinations. At postintervention, between-group effects on change scores (Cohen's d = 0.17–0.75, P <.05) or between-group differences in odds of participating in daily physical activity (odds ratio [OR] = 2.07, P <.05) were detected in six studies, and within-group effects in nine studies (Cohen's d = 0.21–3.97, P <.05). At follow-up, between-group differences in odds of participating in daily physical activity were detected in one study (OR = 2.64, P <.05), and within-group effects in two studies (Cohen's d = 0.25, P <.05). No effects (P <.05) were detected in 17 studies. Conclusion: It may be possible to modify daily physical activity levels and sedentary behavior poststroke; however, there is insufficient evidence to suggest the superiority of a particular intervention approach. Future studies should explore the unique contributions of individual intervention components to guide development of parsimonious multicomponent interventions that are effective for promoting daily physical activity and reducing sedentary behavior among people with stroke. Level of Evidence: I.
UR - http://www.scopus.com/inward/record.url?scp=85074468128&partnerID=8YFLogxK
U2 - 10.1002/pmrj.12222
DO - 10.1002/pmrj.12222
M3 - Article
C2 - 31329372
AN - SCOPUS:85074468128
SN - 1934-1482
VL - 12
SP - 186
EP - 201
JO - PM and R
JF - PM and R
IS - 2
ER -