Physical activity in chronic home-living and sub-acute hospitalized stroke patients using objective and self-reported measures

Background: Despite confirmed reduced physical activity (PA) after stroke in various stages of recovery, the type of activities stroke patients executed and the time spent at different activity levels have not been sufficiently verified with stroke-validated assessment tools. Design: Observational study. Objective: To determine PA of sub-acute stroke patients hospitalized in a rehabilitation centre (HOS) compared to chronic home-living stroke patients (HOM) using objective and self-reported measures during 2 weekdays and 1 weekend day. Methods: Fifteen HOS and 15 HOM patients wore a Sense Wear Pro 2 accelerometer (METs*minutes/24 h) and a knee-worn pedometer Yamax Digi Walker SW 200 (steps) and filled in a coded activity diary (kcal/24 h; METs*minutes/24 h) during three consecutive days. Results: In HOM significantly more steps (steps(total) (HOM) = 18722.6 +/- 10063.6; steps(total) (HOM) = 7097.8 +/- 5850.5) and higher energy expenditure (EE) levels (EEtotal (HOM) = 7759.34 +/- 2243.04; EEtotal (HOM) = 5860.15 +/- 1412.78) were measured. In this group less moderate activity (>= 3-6 <= METs) was performed on a weekday (p(day1) = 0.006; p(day2) = 0.027) and in total (p = 0.037). Few therapy hours (physical, occupational and speech therapy, and psychological support) were provided in HOM compared to HOS (p < 0.001). Vigorous activities were only seen in HOM. In both groups few patients executed sport activities. Conclusions: In HOM significantly more steps were performed and higher EE values were measured. However, participation in moderate activities and time spent on therapy were less in HOM. Evaluating PA with quantitative measures is feasible in both chronic home-living and sub-acute hospitalized patients with stroke.