Changes in the physical activity of acute stroke survivors between inpatient and community living with early supported discharge: an observational cohort study. Issue 4 (December 2016) - Kerr, A.
Abstract: Objective: To describe and compare patterns of physical activity among stroke survivors during their hospital stay and community living with early supported discharge. Design: Observational cohort study of physical activity before and after early supported discharge. Setting: UK National Health Service stroke units and participants' homes. Participants: Forty-one stroke survivors with a mean age of 69 (standard deviation 11) years, and a median Modified Rivermead Mobility Index of 33.5 [interquartile range (IQR) 25.8 to 35.3]. Main outcome measures: The primary outcome measures were time spent in sitting/standing/walking and number of steps taken, as recorded by a physical activity monitor. Results: There were statistical differences ( P < 0.001) for all categories of physical activity. After early supported discharge to the community, participants took more than twice the number of steps {median 474 (IQR 189 to 773) vs. 1193 (IQR 512 to 2856), median difference 636 [95% confidence interval (CI) 262 to 931]} and spent more than double the time in standing [median 51 (IQR 22 to 128) minutes vs. 100 (IQR 51 to 178) minutes, median difference 28 (95% CI 11 to 68)] compared with their hospital stay. Conclusion: Community living with early supported discharge promoted higher levels of physical activity in medically stable stroke survivors. The near-doubling of activity may serve as a guideline for what is achievable during stroke rehabilitation. Clinical Trial Registration: Number UKCRN 15472.