24h movement behavior trajectory and functional recovery after acute stroke: a prospective study.

Abstract

24h movement behavior, including physical activity (PA), sedentary behavior (SB), and sleep(SLP), is independently associated with health after stroke. Few studies have explored the trajectory of 24h movement behavior and its effect on functional recovery in stroke survivors. We conducted a prospective longitudinal study from November 2023 to June 2025. This study was conducted in five hospitals in Henan province. The ActiGraph GT3X+ accelerometer was used to collect 24h movement behavior of 353 stroke survivors at acute phase(T0), 3-month recovery phase (T1), and 6-month sequelae phase (T2) after stroke onset, and functional recovery was evaluated at 12 months (T3) post-stroke. Patients' demographic information, disease-related data, psychological-related indicators and environment-related indicators were collected. The modified Rankin Scale (mRS) was used to assess their functional recovery 12 months after the onset of the disease. Through a prospective longitudinal study, Parallel-Process Latent Class Growth Model(PP-LCGM) was applied to determine the trajectories of 24h movement behavior, logistic regression was used to explore the effects of different trajectories on functional recovery. 298 stroke survivors completed three follow-up visits. Four potential categories of the 24h movement behavior change trajectory were finally identified. Multivariate logistic regression analysis showed that, after adjusting for age, gender, BMI, NRS grade, NIHSS score, BI index, social support, exercise self-efficacy, anxiety, and depression, there was an increased risk of poor prognosis in the 24h movement behavior imbalance group(OR:5.237,95%CI:1.848-14.835) or long-SLP increased-SB decreased-PA group(OR:4.160,95%CI:1.589-10.891) compared with the 24h movement behavior balance group. The results showed that stroke survivors had different 24h movement behavior trajectories after acute stroke, and there was an increased risk of poor prognosis in the 24h movement behavior imbalance group or long-SLP increased-SB decreased-PA group. 24h movement behavior interventions can be developed accordingly.