Modifiable factors are associated with frailty in individuals after chronic stroke: a cross-sectional study.

Abstract

Introduction: Frailty is increasingly common in individuals after chronic stroke and is associated with poor outcomes. The repercussions of this syndrome on chronic stroke individuals are even worse for physical function, however, it may be reversible, requiring investigations into associated and modifiable factors. Physical activity and walking speed are two significant modifiable risk factors for stroke. Thus, this study aimed to investigate whether modifiable variables (level of physical activity and walking speed) are associated with frailty in individuals after chronic stroke, as well as to verify whether these variables contribute to the presence of frailty in these individuals.

Methods: This is a cross-sectional study where individuals with chronic stroke, aged over 18 years, with unilateral involvement, and able to walk with or without assistive devices were included. The dependent variable was Frailty, measured with the Clinical Frailty Scale (CFS). The modifiable factors (independent variables) were the level of physical activity, expressed through the Adjusted Activity Score measured by the Human Activity Profile, and the walking speed, measured with the 10-meter walk test, in m/s. A multiple linear regression analysis was performed to verify the association between the modifiable variables and frailty.

Results: Sixty-one individuals, with a mean age of 62.6±15.7 years, 50.8% men, with a mean time of evolution of 46.4±43.0 months were included. The level of physical activity alone explained 59.2% of the frailty variance (R²=59.2%; F=88.1; p<0.0). Physical activity and walking speed explained 59.9% of the frailty variance (R²=67.1%; F=62.1; p<0.0).

Conclusion: The level of physical activity and usual walking speed were significantly associated with the presence of frailty in individuals after chronic stroke. Strategies aiming to increase the level of physical activity and walking speed may be a path to avoid frailty development in these patients.