Adherence to Physical Activity Recommendations among Stroke Survivors in the United States
Abstract Body: Background: Physical activity is an effective modifiable behavior for preventing recurrent strokes. This study aims to determine the adherence to physical activity recommendations among stroke survivors in the United States. We further compared our findings with the adherence observed among myocardial infarction (MI) survivors.
Methods: We utilized data from the 2011-2019 Behavioral Risk Factor Surveillance System, a nationally representative survey. To establish benchmarks, we referenced the physical activity recommendations outlined in 2011, 2014, and 2021 American Heart Association stroke prevention guidelines. Adherence to recommendations was determined by the respondents' self-reported intensity, duration, and frequency of physical activity. Multivariate logistic regression was used to compare adherence in stroke survivors, MI survivors, and healthy adults.
Results: Among 48,222 stroke survivors in the United States, the overall adherence rates to 2011, 2014, and 2021 physical activity guidelines were 75.4%, 40.2%, and 69.2%. For independently mobile stroke survivors, the adherence rates increased to 78.1%, 42.1%, and 69.9%. When 2021 recommendations were used as a benchmark, older (≥65) stroke survivors were more likely to adhere to recommendations than younger survivors (71.9%vs.62.3%; p<0.0001). However, when the benchmark was changed to the 2011 and 2014 guidelines, which recommended longer exercise durations, the difference between younger and older stroke survivors dissipated. After adjusting for sociodemographic factors and comorbidities, non-Hispanic Black survivors were less likely to adhere to recommendations (aOR,0.81[95%CI,0.7–0.94]), whereas older and higher educated stroke survivors were more likely to adhere to recommendations. Geographically, stroke belt and non-rural residents were less likely to adhere to recommendations [(63.5%vs.67.9%;p<0.0001), (53.8%vs.58.7%;p<0.0001)]. Stroke and MI survivors were less likely to adhere to the latest recommendations than healthy adults (aOR,0.74[95%CI,0.69-0.8], (aOR,0.24[95%CI,0.22-0.26])).
Conclusion: A substantial number of stroke survivors do not meet physical activity recommendations. Tailored interventions should be designed for at-risk populations, e.g., non-Hispanic Black survivors and lower educated stroke survivors.
Vemuri, Ajith
( Penn state university
, Hershey
, Pennsylvania
, United States
)
Hejazian, Sina
( Penn state university
, Hershey
, Pennsylvania
, United States
)
Vafaei Sadr, Alireza
( Pennsylvania State University
, Hershey
, Pennsylvania
, United States
)
Zhou, Shouhao
( Pennsylvania State University
, Hershey
, Pennsylvania
, United States
)
Decker, Keith
( University of Delaware
, Newark
, Pennsylvania
, United States
)
Hakun, Jonathan
( Penn state university
, Hershey
, Pennsylvania
, United States
)
Sciamanna, Christopher
( Pennsylvania State University
, Hershey
, Pennsylvania
, United States
)
Abedi, Vida
( The Pennsylvania State University
, Hershey
, Pennsylvania
, United States
)
Zand, Ramin
( Pennsylvania State University
, Hershey
, Pennsylvania
, United States
)
Author Disclosures:
Ajith Vemuri:DO NOT have relevant financial relationships
| Sina hejazian:DO NOT have relevant financial relationships
| Alireza Vafaei Sadr:DO NOT have relevant financial relationships
| Shouhao Zhou:DO NOT have relevant financial relationships
| Keith Decker:DO NOT have relevant financial relationships
| Jonathan Hakun:No Answer
| Christopher Sciamanna:No Answer
| Vida Abedi:DO NOT have relevant financial relationships
| Ramin Zand:DO NOT have relevant financial relationships