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Finding New Ways to Help Stroke Patients

Novel research targets patient activity level while in the hospital

Sandra Billinger, PT, PhD, with an accelerometer, like the ones used in her studyAre stroke patients getting enough activity in the hospital? Probably not, according to new research at the University of Kansas Medical Center.

Sandra Billinger, PT, PhD, and her team at the Research in Exercise and Cardiovascular Health Laboratory spent 14 months studying 32 stroke patients at The University of Kansas Health System.

Until now, most research on the subject has been observational and performed outside the U.S. Billinger's group – which included a collaborative effort among physicians, nurses, Rehabilitation staff and more – set out to gather quantifiable data closer to home.

They attached activity-measuring accelerometers to patients' ankles for four days, or until they were discharged. The findings: Stroke patients were sedentary nearly 22.5 hours of the day. The team also found a relationship between the patients' activity levels and how well they performed in physical tests at the time of their discharge from the hospital.

Inactivity among stroke patients is a challenge faced by all hospitals. Yet the new study, funded by the National Institutes of Health and published in the July 2015 issue of Journal of Neurological and Physical Therapy, illustrates how an academic medical center can lead the way with research to get stroke patients moving earlier and provide the most advanced care.

"As stroke physicians, we're aware of patients' limited amount of physical activity while hospitalized, but the data from this paper has given us a truly objective idea of how little activity these patients actually get," said endovascular neurologist Michael Abraham, MD, a member of the health system's Acute Stroke Team.

"Research like this is what is needed to change the treatment paradigm in post-stroke therapy," he added. "This is just as important as the acute treatment."

For Billinger and her team, the next step is more research to determine the specific types and duration of exercise needed for stroke inpatients.

"The take-home message," she said, "is that as physical therapists we need to work with the healthcare team to find ways to safely and effectively increase stroke patients' physical activity early after stroke, especially during the hospital stay."