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Unbalanced 24h movement behavior trajectories after acute stroke are associated with increased risk of poor functional recovery at 12 months

In a prospective longitudinal study of 298 stroke survivors, four distinct 24h movement behavior trajectories were identified. Compared to a balanced trajectory, the imbalance group (OR=5.237, 95%CI: 1.848-14.835) and the long-sleep, increased-sedentary, decreased-physical-activity group (OR=4.160, 95%CI: 1.589-10.891) had significantly higher odds of poor functional recovery at 12 months, after adjusting for multiple confounders.

Last updated: Aug 6, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. 24h movement behavior trajectory and functional recovery after acute stroke: a prospective study.

observational

Dong X, Wei J, Yang F, Li C, Sun C, Liu Y · Archives of physical medicine and rehabilitation (2026)

Participants: N/A
Duration: 12 months follow-up
Intervention: Observational study of 24h movement behavior trajectories (physical activity, sedentary behavior, sleep) measured at acute phase (T0), 3 months (T1), and 6 months (T2) post-stroke
Outcome: Functional recovery assessed by modified Rankin Scale (mRS) at 12 months post-stroke
Effect Size: OR=5.237 (95%CI: 1.848-14.835) for imbalance group; OR=4.160 (95%CI: 1.589-10.891) for long-SLP increased-SB decreased-PA group
Population: Stroke survivors (n=298) from five hospitals in Henan province, China

Result:

PubMed: 42542202DOI: 10.1016/j.apmr.2026.07.025

Mechanism Graph

Acute stroke disrupts normal 24h movement behavior patterns
↓
Unbalanced trajectories (e.g., excessive sleep, increased sedentary time, reduced physical activity) may impair neuroplasticity and recovery
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Poor movement behavior may exacerbate cardiovascular and metabolic risks, hindering functional recovery
↓
Result: Increased odds of poor functional outcome at 12 months

Limitations

  • ⚠Observational design cannot establish causality
  • ⚠Potential residual confounding despite adjustment for multiple factors
  • ⚠Sample limited to one region in China, limiting generalizability
  • ⚠Attrition (353 to 298) may introduce selection bias

Frequently Asked Questions

What are the four trajectories of 24h movement behavior identified in stroke survivors?▼

The abstract mentions four potential categories were identified, but the specific names are not listed. The two high-risk groups are '24h movement behavior imbalance' and 'long-SLP increased-SB decreased-PA'.

How was 24h movement behavior measured in this study?▼

The ActiGraph GT3X+ accelerometer was used to collect 24h movement behavior data at three time points: acute phase (T0), 3-month recovery phase (T1), and 6-month sequelae phase (T2).

What was the primary outcome and how was it assessed?▼

The primary outcome was functional recovery at 12 months post-stroke, assessed using the modified Rankin Scale (mRS).

What does the odds ratio of 5.237 for the imbalance group mean?▼

It means that stroke survivors in the 24h movement behavior imbalance group had 5.237 times the odds of poor functional recovery compared to the balanced group, after adjusting for confounders.

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References

  1. 1.Dong X, Wei J, Yang F, Li C, Sun C, Liu Y. "24h movement behavior trajectory and functional recovery after acute stroke: a prospective study.." Archives of physical medicine and rehabilitation, 2026. PMID: 42542202 DOI: 10.1016/j.apmr.2026.07.025
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