title: Physical activity early after stroke and its association to functional outcome 3 months later.
abstract: BACKGROUND
  Early rehabilitation that includes early mobilization and increased amount of motor activity is hypothesized to be one of the most important factors contributing to the beneficial effect of comprehensive stroke unit treatment, whereas too much bed rest is hypothesized to be harmful. The purpose of the present study was to assess the association between early activity/bed rest and functional outcome 3 months later.
  
  
  METHODS
  This was a prospective cohort study including patients with the diagnosis of stroke admitted to Trondheim University Hospital, Norway. Patients were eligible if they were less than 14 days poststroke and did not receive palliative care. Motor activity/bed rest was recorded in the acute phase using a standard method of observation, and the outcome was assessed by the modified Rankin Scale (mRS) score 3 months later. A proportional odds model was used to analyze the association between motor activity/bed rest and outcome. All analyses were adjusted for age, gender, stroke severity, time from stroke to observation, and prestroke function.
  
  
  RESULTS
  A total of 106 patients (mean age 79.0 years, 56.6% men) were included. The odds ratio for a higher mRS score (poor outcome) was 1.04 (95% confidence interval [CI] 1.02-1.07, P = .001) as time in bed increased and .97 (95% CI .93-1.02, P = .283) as time in motor activity increased.
  
  
  CONCLUSIONS
  This study confirms that time in bed in the early phase is associated with poor functional outcome 3 months later, indicating that too much bed rest should be avoided in the early phase after stroke.
authors: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Physiotherapy, Faculty of Health Education and Social Work, Sør-Trøndelag University Collage, Trondheim, Norway. Electronic address: torunn.askim@ntnu.no.
authors: Torunn
authors: T
authors: Askim
authors: Stroke Division, Florey Institutes of Neuroscience and Mental Health, Heidelberg, Victoria, Australia; Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
authors: Julie
authors: J
authors: Bernhardt
authors: Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Oyvind
authors: O
authors: Salvesen
authors: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medicine, Stroke Unit, St. Olavs Hospital, Trondheim, Norway.
authors: Bent
authors: B
authors: Indredavik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001510:Bed Rest / Q000009:adverse effects; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009664:Norway; D016017:Odds Ratio; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome
keywords: Stroke; cerebrovascular disorder; outcome; physical activity; rehabilitation; secondary prevention