%0 Journal Article
%T Physical Activity after Stroke: A Systematic Review and Meta-Analysis
%A Matthew J. Field
%A Nick Gebruers
%A Thavapriya Shanmuga Sundaram
%A Sarah Nicholson
%A Gillian Mead
%J ISRN Stroke
%D 2013
%R 10.1155/2013/464176
%X Background and Purpose. Physical activity is beneficial after stroke, but it is unclear how active stroke survivors are. This systematic review and meta-analysis sought to determine levels of activity and factors predicting activity. Summary of Review: Methods. MEDLINE (1946 to present) and EMBASE (1980 to present) were systematically searched until July 2012. All studies quantifying whole-body-free living physical activity by objective and self-reported methods in a community dwelling population with stroke were included. A random effect meta-analysis was performed. Results. Twenty-six studies were included ( ), of which eleven ( ) contained sufficient data for meta-analysis. There were heterogeneous designs, measurements, and procedures. The studies generally recruited small samples of high-functioning participants. Level of physical activity was generally low in quantity, duration and intensity. Poorer walking ability, specific sensorimotor functions, and low mood were correlates of low physical activity. Meta-analysis generated an estimate of 4355.2 steps/day (95% CI: 3210.4 to 5499.9) with no significant heterogeneity ( = 0). Conclusions. In high-functioning stroke survivors, physical activity including walking was generally low. Strategies are needed to promote and maintain physical activity in stroke survivors. Research is needed to establish reasons for low physical activity after stroke. 1. Introduction Physical activity is defined as ˇ°any bodily movement produced by skeletal muscle that results in energy expenditure above a basal levelˇ± [1] and is associated with improved cardiovascular risk factors including reduced blood pressure [2]. The risk of a first-ever stroke, ischaemic or haemorrhagic, is associated with lower amounts of physical activity [3, 4]. Risk modelling studies, based on data from primary prevention studies, have suggested that physical activity is likely to reduce the risk of recurrent stroke [5]. Thus, the American Heart Association (AHA) recommends 20¨C60 minutes medium to high intensity exercise (expressed as 40¨C70% of either peak oxygen uptake or heart rate reserve) in 3¨C7 days per week for stroke survivors [6]. Therefore, it is important to understand whether stroke survivors meet AHA recommendations for physical activity after stroke and the factors associated with the amount and intensity of physical activity patterns. The most methodologically robust way to synthesise results of observational studies is by systematic review and meta-analysis. To our knowledge, the amount of physical activity performed after stroke has
%U http://www.hindawi.com/journals/isrn.stroke/2013/464176/