In the first 6 months after a stroke, is there an association between physical activity trajectories and functional recovery? JAMANetworkOpen goteborgsuni stroke rehabilitation recovery exercise activity functional research
By Neha MathurMay 3 2023Reviewed by Lily Ramsey, LLM In a recent study published in the JAMA Network Open, researchers performed a cohort study using prospectively collected longitudinal data of 1,500 participants of the Efficacy of Fluoxetine—a Randomized Controlled Trial in Stroke study.
In this study, the researchers recruited participants aged >18 years between two and 15 days after stroke onset and followed up with them for six months. They performed data analyses between August 15 and October 28, 2022. Longitudinal studies have shown that some clinical factors could help regain prior physical activity levels following stroke. Some studies showed that patients with stroke were physically active during rehabilitation tenure but became inactive post-discharge. However, they did not consider all temporal and inter-person variations in the long term.
They used the National Institutes of Health Stroke Scale to assess their stroke severity. It helped them categorize strokes into three sublevels: very mild, mild, and moderate-to-severe, as indicated by NIHSS scores ranging between zero to three, four to five, and ≥6, respectively. They rated one's physical activity levels using the 4-level Saltin-Grimby Physical Activity Level Scale . SGPALS 1-4 indicated inactivity, light-intensity, moderate-intensity, and vigorous-intensity exercise for at least four hours per week.
They also conducted subgroup analyses to explore the interaction effects between each subgroup and study group in this model and presented results as odds ratios and 99% confidence intervals . Male participants and those with normal cognition had a higher likelihood of increasing physical activity, regardless of stroke severity.
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The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey - BMC Public HealthAims This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke. Methods We obtained data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model. Results We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (| 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04–3.81), 2.36 (1.52–3.59), 2.34 (1.44–3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65–0.84), sensitivity was 0.68, and specificity was 0.75. Conclusion Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.
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