Walking and Sitting Time after a Stroke: A Comparison of Shifts and Changes over Time within an Acute Care Setting

Featured Application: Facilitating activity during the evening shift and reducing reliance on sitting as the major means of performing out-of-bed activity are possible avenues to increase overall physical activity among patients post-stroke in acute hospital settings. Early activity post-stroke reduces secondary complications and improves rehabilitation outcomes. This study aimed to describe the physical activities of stroke patients in an acute hospital setting, compare activity patterns between working shifts, and assess associations between activity and clinical status. Twenty-one patients (mean age 69.4 ± 33.4 years,13 men) admitted due to acute ischemic stroke wore activity monitors for two weeks or until discharge. During the morning and evening shifts, the activity monitor collected daily data on walking and body position. The study discovered that patients’ overall activity levels were low and that activity was higher during morning shifts than evening shifts (sitting time: 185.31 ± 109.31 min and 91.8 ± 98.46 min, p = 0.002; number of steps: 58.3 ± 32.73 and 30.4 ± 17.6 steps, p < 0.001). Upright and sitting time increased in morning shifts (p = 0.002), while the number of steps increased in both morning and evening shifts (p = 0.002). In the evening shift, there was a fair (r = 0.28, p = 0.02) positive correlation between grip strength and the number of steps, such that patients with higher grip strength took more steps. In addition, there were poor (r = −0.2, p = 0.02) correlations between motor function (Trunk Control Test and Functional Ambulation Category) and time in an upright position, such that patients with lower functional ability sat longer. Clinical characteristics and level of activity did not show any other correlations. To conclude, the main out-of-bed activity of patients was sitting during morning shifts. The findings highlight the temporal differences in activity throughout the day, as well as the disconnect between clinical characteristics and activity levels.