ORCID Profile
0000-0003-3158-4750
Current Organisation
Northumbria University
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Publisher: SAGE Publications
Date: 23-12-2014
Abstract: Background. Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke. Objective. To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke. Methods. A total of 40 participants ( years, months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, “exercise” group) or stretching (“control” group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function. Results. Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97 CI = −0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min P .05 CI = 9.0 to 0.1) without any change in gray matter tissue volume. There was no change in medial temporal lobe tissue blood flow in the control group (41 ± 8 to 40 ± 7 mL/100 g/min P = .13 CI = −3.6 to 6.7) but significant gray matter atrophy. Cardiorespiratory fitness, diastolic blood pressure, high-density lipoprotein cholesterol, physical function, and cognition also improved with exercise. Conclusion. Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored.
Publisher: Informa UK Limited
Date: 16-08-2016
Publisher: BMJ
Date: 27-06-2011
Publisher: BMJ
Date: 30-06-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-03-2021
DOI: 10.1097/NPT.0000000000000357
Abstract: Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished? This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time. Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts ( P 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P 0.001 – P = 0.002. Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be in idually tailored. Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: links.lww.com/JNPT/A343).
Publisher: Elsevier BV
Date: 04-2016
Publisher: Public Library of Science (PLoS)
Date: 29-01-2013
Publisher: SAGE Publications
Date: 24-06-2023
DOI: 10.1177/17474930231184108
Abstract: Physical activity is important for secondary stroke prevention. Currently, there is inconsistency of outcomes and tools used to measure physical activity following stroke. To establish internationally agreed recommendations to enable consistent measurement of post-stroke physical activity. Stroke survivors and carers were surveyed online once regarding what is important in physical activity measurement. Three survey rounds with expert stroke researchers and clinicians were conducted using Keeney’s Value-Focused Thinking Methodology. Survey 1 identified physical activity tools, outcomes, and measurement considerations which were ranked in Survey 2. Consensus recommendations on tools were then formulated by the consensus group based on survey responses. In Survey 3, participants reviewed ranked results and evidence gathered to determine their support for consensus recommendations. Twenty-five stroke survivors, 5 carers, 18 researchers, and 17 clinicians from 16 countries participated. Time in moderate-vigorous physical activity and step count were identified as the most important outcomes to measure. Key measurement considerations included the ability to measure across frequency, intensity, duration domains in real-world settings user-friendliness, comfort, and ability to detect changes. Consensus recommendations included using the Actigraph, Actical, and Activ8 devices for physical activity intensity ActivPAL for duration and Step Activity Monitor for frequency and the IPAQ and PASE questionnaires. Survey 3 indicated 100% support for device and 96% for questionnaire recommendations. These consensus recommendations can guide selection of physical activity measurement tools and outcomes. Tool selection will depend on measurement purpose, user-knowledge, and resources. Comprehensive measurement requires the use of devices and questionnaires.
Publisher: Informa UK Limited
Date: 18-02-2019
Publisher: Springer Science and Business Media LLC
Date: 11-01-2012
DOI: 10.1007/S10877-012-9334-4
Abstract: Bioreactance is a novel non-invasive method for cardiac output measurement that involves the analysis of blood flow-dependent changes in the phase shifts of electrical currents applied across the chest. The present study (1) compared resting and exercise cardiac outputs determined by bioreactance and bioimpedance methods and those estimated from measured oxygen consumption, (2) determined the relationship between cardiac output and oxygen consumption, and (3) assessed the agreement between the bioreactance and bioimpedance methods. Twelve healthy subjects (aged 30 ± 4 years) performed graded cardiopulmonary exercise test on a recumbent cycle ergometer on two occasions, 1 week apart. Cardiac output was monitored at rest, at 30, 50, 70, 90, 150 W and at peak exercise intensity by bioreactance and bioimpedance and expired gases collected. Resting cardiac output was not significantly different between the bioreactance and bioimpedance methods (6.2 ± 1.4 vs. 6.5 ± 1.4 l min(-1), P = 0.42). During exercise cardiac outputs were correlated with oxygen uptake for both bioreactance (r = 0.84, P < 0.01) and bioimpedance techniques (r = 0.82, P < 0.01). At peak exercise bioimpedance estimated significantly lower cardiac outputs than both bioreactance and theoretically calculated cardiac output (14.3 ± 2.6 vs. 17.5 ± 5.2 vs. 16.9 ± 4.9 l min(-1), P < 0.05). Bland-Altman analyses including data from rest and exercise demonstrated that the bioimpedance method reported ~1.5 l min(-1) lower cardiac output than bioreactance with lower and upper limits of agreement of -2.98 to 5.98 l min(-1). Bioimpedance and bioreactance methods provide different cardiac output estimates, particularly at high exercise intensity, and therefore the two methods cannot be used interchangeably. In contrast with bioimpedance, bioreactance cardiac outputs are similar to those estimated from measured oxygen consumption.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2012
DOI: 10.1161/STROKEAHA.111.649434
Abstract: Understanding the physiological limitations to exercise after stroke will assist the development of targeted therapies to improve everyday function. This study defines (1) whether exercise capacity is limited by the cardiovascular system (oxygen supply) or skeletal muscles (oxygen utilization) and (2) cardiac function and pumping capability in people with stroke. Twenty-eight male participants with mild ischemic stroke (70±6 years of age, 18±20 months poststroke) and 25 male, age-matched healthy control subjects performed a graded cardiopulmonary exercise test with gas exchange and noninvasive hemodynamic measurements. Maximal oxygen extraction was calculated as the ratio between peak oxygen consumption and peak cardiac output. Cardiac function and pumping capability were assessed by peak exercise cardiac power output (expressed in watts) and cardiac output. Peak oxygen consumption (18.4±4.6 versus 26.8±5.5 mL/kg/min, P .01) and arterial–venous O 2 difference (9.3±2.5 versus 12.6±1.9 mlO 2 /100 mL of blood, P .01) were both reduced in stroke participants compared with healthy control subjects. In contrast, peak exercise cardiac power output (4.79±0.79 versus 4.51±0.96 W, P =0.49), cardiac output (16.4±3.1 versus 17.1±2.5 L/min, P =0.41), and the pressure-generating capacity of the heart (127±11 versus 125±14 mm Hg, P =0.97) were similar between stroke participants and healthy control subjects. The ability of skeletal muscles to extract oxygen is diminished after stroke. However, cardiac function and pumping capability are maintained. Appropriate therapies targeting muscle oxygen uptake such as exercise rehabilitation may improve exercise capacity after stroke.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
DOI: 10.1161/STROKEAHA.111.646257
Abstract: Current means of assessing physical activity and energy expenditure have restrictions in stroke, limiting our understanding of its role in therapeutic management. This study validates a portable multisensor array for measuring free-living total energy expenditure compared with a gold standard method (doubly labeled water) in in iduals with stroke. Daily energy expenditure was measured in 9 participants with stroke (73±8 years) over a 10-day period with 2 techniques: a portable multisensor array and doubly labeled water. Bland-Altman analysis revealed a mean difference of 94 kcal/day (3.8%) in total energy expenditure measures given by the multisensor array in comparison to doubly labeled water with lower and upper limits of agreement of −276 to 463.8 kcal/day (2473±468 versus 2380±551, P =0.167). There was strong agreement between the multisensor array and labeled water methods of capturing total daily energy expenditure ( r =0.850, P =0.004). The multisensor array is a portable and accurate method of capturing daily energy expenditure and may assist in understanding how stroke influences free-living energy expenditure and aid in clinical management.
Publisher: Oxford University Press (OUP)
Date: 07-03-2011
DOI: 10.1093/QJMED/HCR029
Abstract: Chronic fatigue syndrome (CFS) is a common debilitating condition associated with reduced function and impaired quality of life. The cause is unknown and treatments limited. Studies confirm that CFS is associated with impaired autonomic regulation and impaired muscle function. Define the relationship between sedentary behaviour, physical activity and autonomic regulation in people with CFS. Cohort study. Physical activity was assessed objectively in 107 CFS patients (Fukuda) and age, sex and body mass index (BMI)-matched sedentary controls (n= 107). Fatigue severity was determined using the Fatigue Impact Scale in all participants and heart rate variability performed in the CFS group. The CFS group had levels and patterns of sedentary behaviour similar to non-fatigue controls (P > 0.05). Seventy-nine percent of the CFS group did not achieve the WHO recommended 10,000 steps per day. Active energy expenditure [time >3 METs (metabolic equivalents)] was reduced in CFS when compared with controls (P < 0.0001). Physical activity duration was inversely associated with resting heart rate (P = 0.04 r(2) = 0.03), with reduced activity significantly associating with reduced heart rate variability in CFS. There were no relationships between fatigue severity and any parameter of activity. Thirty-seven percent of the CFS group were overweight (BMI 25-29.9) and 20% obese (BMI ≥ 30). Low levels of physical activity reported in CFS represent a significant and potentially modifiable perpetuating factor in CFS and are not attributable to high levels of sedentary activity, rather a decrease in physical activity intensity. The reduction in physical activity can in part be explained by autonomic dysfunction but not fatigue severity.
Publisher: BMJ
Date: 07-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2022
DOI: 10.1161/STROKEAHA.122.038956
Abstract: Achieving safe, independent, and efficient walking is a top priority for stroke survivors to enable quality of life and future health. This narrative review explores the state of the science in walking recovery after stroke and potential for development. The importance of targeting walking capacity and performance is explored in relation to in idual stroke survivor gait recovery, applying a common language, measurement, classification, prediction, current and future intervention development, and health care delivery. Findings are summarized in a model of current and future stroke walking recovery research and a mission statement is set for researchers and clinicians to drive the field forward to improve the lives of stroke survivors and their carers.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sarah Moore.