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Background and purpose: Evidence regarding whether reducing sedentary behavior and increasing physical activity levels to prevent stroke recurrence is insufficient. Therefore, this study preliminarily investigated whether post‐discharge sedentary behavior and physical activity levels in patients with minor ischemic stroke were associated with stroke recurrence. Methods: This retrospective observational study included 73 patients (aged 72.0 years) with minor ischemic stroke from a previous study. The outcome was recurrent stroke 2 years after stroke onset, assessed using medical records. Exposure factors including sedentary behavior and physical activity levels 6 months post‐discharge were measured using accelerometers; patients were classified into the recurrence or non‐recurrence groups. Logistic regression analyses were then conducted to determine whether sedentary behavior and physical activity 6 months after discharge were associated with stroke recurrence. Results: Six patients experienced stroke recurrence (recurrence rate, 8.2%). The recurrence group showed greater sedentary behavior (recurrence group 68.0%, non‐recurrence group 52.0%, p = 0.007) and less light‐intensity physical activity (LPA) (recurrence group 21.0%, non‐recurrence group 37.0%, p = 0.002) than in the non‐recurrence group. Logistic regression analysis showed that sedentary behavior (odds ratio = 1.083, 95% confidence interval = 1.007–1.165, p = 0.032) and LPA (odds ratio = 0.874, 95% confidence interval = 0.785–0.975, p = 0.015) were independent factors for recurrence of stroke. Discussion: Post‐discharge sedentary behavior and LPA in patients with minor ischemic stroke were associated with stroke recurrence. Results suggest that reducing post‐discharge sedentary behavior and increasing LPA may be crucial for reducing the risk of stroke recurrence in patients with minor ischemic stroke. [ABSTRACT FROM AUTHOR]

The relationship between chronic pain and the occurrence of falls in healthy older adults has been clarified in previous studies, but its relationship in older adults with disabilities has not. This study aimed to determine whether chronic pain is related to the occurrence of falls in older adults with disabilities. The participants were 101 older adults above 65 years old who used long-term care insurance services in Japan. Of these, 30 were fallers and 71 were non-fallers. Chronic pain, defined as pain lasting more than three months, was assessed using questionnaires, and the falls' occurrence was followed up for six months using a fall calendar. Logistic regression analysis was used to analyze the data, with falls as the dependent variable, chronic pain as the independent variable, and age, sex, body mass index, number of drugs, sleep disorders, and depression as covariates. After adjusting for covariates, chronic pain significantly influenced the occurrence of falls (odds ratio: 3.168, 95% confidence interval: 1.057–9.495, p =.04). Chronic pain was related to the occurrence of falls in older adults with disabilities. There is a need to focus on chronic pain presence in falls' prevention among older adults with disabilities. [ABSTRACT FROM AUTHOR]

The purpose of this single-masked randomized clinical trial was to examine whether nonleisure-time physical activity guidance (NLTPAG) improves physical activity levels in patients after minor ischemic stroke. Patients who had been hospitalized for minor ischemic stroke in an acute care hospital (National Health Institute Stroke Scale ≤ 5) were randomized to either an NLTPAG group (n = 17) or a leisure-time physical activity guidance group (n = 16). NLTPAG focused on reducing sedentary behavior and increasing the frequency of walking for shopping and household activities to improve physical activity levels in daily life. Physical activity levels significantly improved only in participants in the NLTPAG group (initial assessment: metabolic equivalents of task = 12.6; final assessment: metabolic equivalents of task = 14.8; p =.035, r =.51). These results suggest that NLTPAG may be effective for improving physical activity levels in patients after minor ischemic stroke. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effects on sedentary behaviour of an approach that promotes reduction in sedentary behaviour in patients with minor ischaemic stroke after intervention and at follow-up. Design: A randomised controlled trial. Setting: During hospitalisation and after hospital discharge Subjects: In total, 86 patients with minor ischaemic stroke admitted to an acute care hospital were assigned to the intervention (n = 43) and control (n = 43) groups. Intervention: An intervention group that received an approach to reduce sedentary behaviour upon hospital admission until 3 months after discharge (education, self-monitoring, phone calls, etc.) and a control group that received the usual care during hospitalisation. From 3 to 6 months after discharge, no group received any intervention. Main Outcome: The primary outcome was the change (%) in sedentary behaviour from baseline to post-intervention (3 months after discharge) and follow-up (6 months after discharge). Sedentary behaviour was measured at baseline (upon hospital admission), post-intervention, and at follow-up using accelerometers. Results: At the post-intervention stage, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −22.7%; control group, −14.9%; P = 0.013; effect size = 0.58). At follow-up too, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −20.4%; control group, −13.6%; P = 0.025; effect size = 0.54). Conclusions: An approach to reduce sedentary behaviour in patients with minor ischaemic stroke effectively reduces sedentary behaviour, which is sustained up to follow-up. Trial registration: This study is registered at www.umin.ac.jp/ctr/index/htm UMIN000038616. [ABSTRACT FROM AUTHOR]

The association between depression and chronic pain has been clearly demonstrated in healthy older adults, but not in older adults with disabilities. This study thus aimed to clarify the association between depression and chronic pain in older adults with disabilities. In total, 92 older adults aged 65 years or older subscribed to Japanese long-term care insurance services were included in this study. Depression was assessed using the Geriatric Depression Scale-Short Version-Japanese (GDS-S-J) and was diagnosed among respondents who scored 6 or more points. Chronic pain was assessed using a questionnaire and defined as a "pain that persists in the present and has lasted for more than three months." Chronic pain was associated with depression in older adults with disabilities (odds ratio: 3,355, 95% confidence interval: 1,232–9,135, p = 0,018). There was a strong association between severe chronic pain and depression (odds ratio: 3,699, 95% confidence interval: 1,345–10,173, p = 0,011). Our findings suggest that it is necessary to focus on intensity of chronic pain to improve depression in older adults with disabilities who are more difficult to treat than healthy older adults. [ABSTRACT FROM AUTHOR]

• We investigated the mediators of chronic pain and falls in frail elderly people. • Mediating factors included previously reported factors as well as sleep disorders and depression. • Sleep disorder was a mediator of chronic pain and falls in the frail elderly. • It is suggested that interventions for chronic pain and sleep disorders should focus on preventing falls in the frail elderly. Previous studies have highlighted the causation between chronic pain and falls in the elderly, but the mediator variables between chronic pain and falls in the frail elderly have not been identified. The purpose of this study was to identify the mediator variable of chronic pain and falls. This study is a prospective cohort study. Participants were 116 frail elderly individuals living in a community. Chronic pain (pain lasting more than 3 months) was assessed using a questionnaire, and the occurrence of falls was tracked using a falls calendar. Using logistic regression, a model was created with falls as the dependent variable and chronic pain and confounders as independent variables. The mediation analysis was conducted with chronic pain as the independent variable, falls as the dependent variable, and factors that showed significant differences between the chronic pain group and the non-chronic pain group as candidate mediators. Even after adjusting for covariates, chronic pain significantly influenced the occurrence of falls (odds ratio: 3.004, 95% CI [1.226, 7.363], p =0.016). The results of mediation analysis showed a significant direct effect between chronic pain and falls, and a significant indirect effect (partial mediation) of sleep disorders on the relationship between chronic pain and falls. Chronic pain in frail elderly mediates sleep disorders and influences falls. It is suggested that interventions for chronic pain and sleep disorders should focus on preventing falls in the frail elderly. [ABSTRACT FROM AUTHOR]