title: Is early rehabilitation a myth? Physical inactivity in the first week after myocardial infarction and stroke.
abstract: OBJECTIVE
  To compare physical activity levels of patients in the first week after myocardial infarction (MI) and stroke.
  
  
  METHODS
  We conducted an observational study using behavioural mapping. MI patients were consecutively recruited from Alfred Hospital, Melbourne. Data for stroke patients (Royal Perth Hospital or Austin Hospital, Melbourne) were retrieved from an existing database. Patients were observed for 1 min every 10 min from 8 am to 5 pm. At each observation, the patient's highest level of physical activity, location and people present were recorded. Details of physiotherapy and occupational therapy sessions were recorded by the therapists.
  
  
  RESULTS
  Proportion of the day spent physically inactive was lower in MI (n = 32, median 48%) than stroke (n = 125, median 59%) patients, but this difference was not significant in univariate or multivariate (adjusting for age, walking ability and days post-event) regression. Time spent physically active was higher in MI (median 23%) than stroke (median 10%) patients (p = 0.009), but this difference did not survive multivariate adjustment (p = 0.67). More stroke patients (78%) than MI patients (19%) participated in therapy.
  
  
  CONCLUSIONS
  This study provides the first objective data on physical activity levels of acute MI patients. While they were more active than acute stroke patients, the difference was largely attributable to walking ability. Implications for rehabilitation In the first week after myocardial infarction, patients spent about half the day physically inactive (even though 81% were able to walk independently). Similar levels of inactivity were seen in a comparable cohort of acute stroke patients, suggesting that environmental factors play an important role. There appears to be wide scope for increasing levels of physical rehabilitation after acute cardiovascular events, though optimal timing and dose remain unclear.
authors.affiliation: a Department of Physiotherapy , La Trobe University , Bendigo , Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lay
authors.affiliation: b Florey Institute of Neuroscience and Mental Health , University of Melbourne , Melbourne , Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
authors.affiliation: c Department of Allied Health , Fiona Stanley Hospital , Perth , Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: West
authors.affiliation: b Florey Institute of Neuroscience and Mental Health , University of Melbourne , Melbourne , Australia.
authors.forename: Leonid
authors.initials: L
authors.lastname: Churilov
authors.affiliation: d Department of Cardiovascular Medicine , Alfred Health , Melbourne , Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dart
authors.affiliation: d Department of Cardiovascular Medicine , Alfred Health , Melbourne , Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Hayes
authors.affiliation: b Florey Institute of Neuroscience and Mental Health , University of Melbourne , Melbourne , Australia.
authors.forename: Toby B
authors.initials: TB
authors.lastname: Cumming
keywords: Acute; cardiovascular disease; exercise; mobilisation