{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T05:23:58Z","timestamp":1794374638124,"version":"4.9.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Low physical activity (PA) is associated with poor health outcomes after stroke. Step counts are a common metric of PA; however, other physiologic signals (eg, heart rate) may help to identify subgroups of individuals poststroke at varying levels of risk of poor health outcomes. Here, we aimed to identify clinically relevant subgroups of individuals poststroke based on PA profiles that leverage multiple data sources, including step count and heart rate data, from wearable devices.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Seventy individuals poststroke participated. Participants wore a Fitbit Inspire 2 for 1\u2009year and completed clinical assessments. We defined a group\u2010based steps\u2010per\u2010minute threshold and an individual heart rate threshold to categorize each minute of PA into 1 of 4 states: high steps\/high heart rate, low steps\/low heart rate, high steps\/low heart rate, and low steps\/high heart rate. We used the proportion of time spent in each state along with steps per day, sedentary time, mean steps among minutes with high steps and high heart rate, and resting heart rate in a k\u2010means clustering algorithm to identify subgroups and compared Activity Measure for Post\u2010Acute Care Mobility T Score, Stroke Impact Scale, and gait speed among subgroups. We identified 3 subgroups, Active (n=8), Sedentary (n=29), and Deconditioned (n=33), which differed significantly on all clustering variables except resting heart rate. We observed significant differences in Activity Measure for Post\u2010Acute Care Mobility T scores between subgroups, with the Deconditioned subgroup exhibiting the lowest score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Quantifying PA with heart rate and step count using readily available wearable devices can identify clinically meaningful subgroups of individuals poststroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030577","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T11:10:30Z","timestamp":1694171430000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Identifying Unique Subgroups of Individuals With Stroke Using Heart Rate and Steps to Characterize Physical Activity"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2896","authenticated-orcid":false,"given":"Lily J.","family":"Koffman","sequence":"first","affiliation":[{"name":"Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-3881","authenticated-orcid":false,"given":"Ciprian M.","family":"Crainiceanu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0797-6455","authenticated-orcid":false,"given":"Ryan T.","family":"Roemmich","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Johns Hopkins School of Medicine Baltimore MD"},{"name":"Center for Movement Studies Kennedy Krieger Institute Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-7374","authenticated-orcid":false,"given":"Margaret A.","family":"French","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Johns Hopkins School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1310\/tsr2103-246"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269215516640863"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/959120"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000022"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/10749357.2020.1799292"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2019.07.006"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly029"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160644"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.027013"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03644-0"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/17474930211006293"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17155518"},{"key":"e_1_3_2_14_2","volume-title":"Exercise Physiology for Health Fitness and Performance","author":"Plowman SA","year":"2013","unstructured":"Plowman SA, Smith DL. Exercise Physiology for Health Fitness and Performance. Lippincott Williams & Wilkins; 2013."},{"key":"e_1_3_2_15_2","volume-title":"Exercise Physiology: Energy, Nutrition, and Human Performance","author":"McArdle WD","year":"1991","unstructured":"McArdle WD, Katch FI, Katch VL. Exercise physiology. Exercise Physiology: Energy, Nutrition, and Human Performance. LWW; 1991."},{"key":"e_1_3_2_16_2","first-page":"149","volume-title":"Cardiology: Current Topics and Progress","author":"Fox S","year":"1970","unstructured":"Fox S, Haskell W. The exercise stress test: needs for standardization. Cardiology: Current Topics and Progress. Academic Press; 1970:149\u2013154."},{"key":"e_1_3_2_17_2","first-page":"950","article-title":"Physical activity and the prevention of coronary heart disease","volume":"44","author":"Fox SM","year":"1968","unstructured":"Fox SM, Haskell WL. Physical activity and the prevention of coronary heart disease. 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