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Julie Bernhardt, Numthip Chitravas, Ingvild Lidarende Meslo, Amanda G. Thrift, and
Not All Stroke Units Are the Same. A Comparison of Physical Activity Patterns in
Melbourne, Australia, and Trondheim, Norway
Stroke published May 1, 2008, doi:10.1161/STROKEAHA.107.507160
Abstract 1 of 1
Submitted on October 13, 2007
Revised on December 6, 2007
Accepted on December 13, 2007
Not All Stroke Units Are the Same. A Comparison of Physical
Activity Patterns in Melbourne, Australia, and Trondheim,
Julie Bernhardt PhD*; Numthip Chitravas MD; Ingvild Lidarende Meslo PT; Amanda G. Thrift
PhD; and Bent Indredavik MD, PhD
From the National Stroke Research Institute (J.B., N.C., A.G.T.), Austin Health, Heidelberg Heights, Australia; La
Trobe University (J.B.), Melbourne, Australia; St Olav's University Hospital (L.M., B.I.), Trondheim, Norway; the
Department of Neuroscience (B.I.), Faculty of Medicine, Norwegian University of Science and Technology,
Trondheim, Norway; Baker Heart Research Institute (A.G.T.), Melbourne, Australia; and the Department of Medicine
(N.C.), School of Medicine, Case Western Reserve University, Cleveland, Ohio.
* To whom correspondence should be addressed. E-mail: J.Bernhardt@unimelb.edu.au .
Background and Purpose—Very early mobilization may be one of the most important factors
contributing to the favorable outcome observed from a stroke unit in Trondheim, Norway. The aims
of this study were to (1) describe and compare the pattern of physical activity of patients with stroke
managed in a stroke unit with specified mobilization protocols (Trondheim) and those without in
Melbourne, Australia; and (2) identify differences in activity according to stroke severity between
the 2 sites.
Methods—Melbourne patients were recruited from 5 metropolitan stroke units. Trondheim patients
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were recruited from the stroke unit at University Hospital, Trondheim. All patients <14 days Download full-text
poststroke were eligible for the study. Patients receiving palliative care were excluded. Consenting
participants were observed at 10-minute intervals from 8:00 AM to 5:00 PM over a single day. At
each observation, patient location, activity, and the people present were recorded. Negative
binomial regression analyses were undertaken to assess differences in physical activity patterns
between stroke units in the 2 cities.
Results—Patients in Melbourne and Trondheim had similar baseline characteristics. Melbourne
patients spent 21% more time in bed and only 12.2% undertook moderate/high activity (versus
23.2% in Trondheim, P<0.001). This difference was even more pronounced among patients with
greater stroke severity. The incidence rate ratio for time spent doing standing and walking activities
in Melbourne was 0.44 (95% CI: 0.32 to 0.62) when compared with Trondheim.
Conclusion—Higher activity levels were observed in Trondheim patients, particularly among those
with more severe strokes. A greater emphasis on mobilization may make an important contribution
to improved outcome. Further investigation of this is warranted.
Key words: early mobilization • rehabilitation • stroke • stroke units
[Reprint (PDF) Version of Bernhardt et al.]
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