Sitting less and moving more helps stroke patients regain their mobility, research shows

Research from the University of Alberta provides new recovery advice for stroke patients based on a precision health approach.

“There are many links between the amount of time people spend sitting, or not moving, and health problems,” says Victor Ezeugwu, an assistant professor in the Department of Rehabilitation Medicine and a member of the Neuroscience and Mental Health Institute. His research in clinical settings focuses on movement behavior.

“We’re taking a one-size-fits-all approach, but we know that doesn’t work for everyone,” Ezeugwu notes. “Getting people to do higher intensity physical activity after a stroke remains a big challenge. We know that increasing daily repetitions and task-specific exercises promotes neuroplasticity and recovery.”

Ezeugwu and colleagues examined functional outcomes in neurological patients, such as people recovering from a stroke, to test the associations between exercise and changes in functional outcomes following a “sit less, move more” intervention.

The findings, published in Disability and rehabilitationshowed that, compared with a decrease in other types of exercise, reallocating at least 30 minutes per day or 40 minutes per day to walking is associated with improvements in functional mobility or gait speed, respectively, after stroke.

The team is now investigating the effect of a ‘sit less, move more, sleep better’ intervention on improving quality of life when implemented within seven days of the onset of stroke symptoms. the study protocol published end of 2023 in PLOS One.

“I use theories of behavior change that are primarily used in healthy populations, but that can also be applied to patient populations. For example, I want to see how we can help patients spend less time sitting and become more active,” Ezeugwu said.

Long-term sedentary behavior is particularly harmful to health. Research shows that people who spend less time inactive actually experience many benefits.

“There have been studies that show a link between how much people sit and things like cardiometabolic disease, increased risk of diabetes, heart disease and certain cancers,” Ezeugwu said.

Stroke patients may have reduced mobility during their recovery, he explains, and some patients may not be able to move as they used to.

“That’s why we focus more on reducing sedentary behavior.”

According to Ezeugwu, most studies have focused on moderate to vigorous physical activity in chronic stroke survivors within six months of the stroke, but have not taken into account how recovering patients spend their entire day.

“While we know that exercise works, it only takes up a small part of the day, less than 5%. What is often not considered is the remaining 95% of the day. We need to take a step back, especially in the early stages of stroke, to look at how we can help people reduce their sedentary time.”

To provide personalized recovery advice to patients, Ezeugwu uses a precision health approach, which uses innovative technology to account for health-related factors. This allows for disease diagnosis and treatment to be tailored to individuals and populations.

Ezeugwu is now working on how to more accurately monitor patients with baseline activity measurements in the first seven days after a stroke, in the hope that this will give researchers insight into how someone is doing.

“We think that with more accurate measurements of ground motion, we can better predict how quickly we recover,” he says.

According to Ezeugwu, using just one marker may not be enough. The researchers believe that combining two markers, such as imaging and behavioral measures, may be more accurate in predicting who will do well and who will not.