{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:19:44Z","timestamp":1787861984424,"version":"build-2784847793"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec id=\"jah310988-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although physical activity correlates with reduced depressive symptoms among survivors of stroke, how frequency, intensity, and duration of physical activity relate to mental health is unknown. This study aims to find the association of physical activity doses recommended in 2011, 2014, and 2021 American Heart Association\/American Stroke Association guidelines with mental health burden (number of days of poor mental health). Analysis was expanded to find the optimal dose linked to mental health burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310988-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We used data from the 2011 to 2019 Behavioral Risk Factor Surveillance System, a nationally representative survey. The mental health burden between guideline\u2010adherent and nonadherent groups was compared. Propensity score matching was used to balance the 2 groups with respect to sociodemographic factors and comorbidities. The relative difference in mental health burden between the groups is reported. The impact of duration, frequency, and intensity was analyzed using nonlinear regression, adjusting for potential confounders. We further performed a comparative analysis among survivors of myocardial infarction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310988-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Survivors of stroke who adhered to 2011, 2014, and 2021 guidelines had 0.6, 0.8, and 0.3 fewer days of poor mental health, with relative differences of 11.1%, 14.8%, and 5.8%, respectively. Among survivors of stroke adhering to 2014 guidelines (3\u20134\u2009sessions\/week, 40\u2009minutes\/session), younger (18\u201364) individuals showed greater relative differences in mental health burden at 15.7%. For those adhering to 2021 guidelines (4 moderate 10\u2010minute or 2 vigorous 20\u2010minute sessions), older (\u226565) individuals had higher relative differences at 11.1%. Regression analysis showed that the optimal dose is 4 to 6 weekly sessions of moderate physical activity, each lasting 45\u2009minutes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310988-sec-0004\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The findings suggest that physical activity doses recommended in 2011, 2014, and 2021 American Heart Association\/American Stroke Association guidelines are associated with lower mental health burden. Furthermore, the amount of physical activity associated with lower mental health may vary by subpopulations (eg, age). Randomized control trials are needed to validate the optimal dose.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.041189","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T07:17:22Z","timestamp":1750663042000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Physical Activity Dose and Mental Health Among Stroke Survivors"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5603-1732","authenticated-orcid":false,"given":"Ajith Kumar","family":"Vemuri","sequence":"first","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-1539","authenticated-orcid":false,"given":"Seyyed Sina","family":"Hejazian","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5733-6678","authenticated-orcid":false,"given":"Alireza Vafaei","family":"Sadr","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1378-1198","authenticated-orcid":false,"given":"Aishwarya","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"University of Delaware","place":["Newark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasan","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8124-5047","authenticated-orcid":false,"given":"Shouhao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Hakun","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Sciamanna","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-933X","authenticated-orcid":false,"given":"Vida","family":"Abedi","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9477-0094","authenticated-orcid":false,"given":"Ramin","family":"Zand","sequence":"additional","affiliation":[{"name":"Pennsylvania State University","place":["Hershey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003534"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.4315"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.15030363"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155221135412"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2024.07.005"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18158058"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1123\/jpah.2015-0446"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3857"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000437"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90354-5"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095786"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13003"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.963950"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-193013"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12823"},{"key":"e_1_3_2_18_2","first-page":"A1","volume-title":"Physical Activity Guidelines Advisory Committee Report, 2008","author":"Committee PAGA","year":"2008","unstructured":"Committee PAGA . Physical Activity Guidelines Advisory Committee Report, 2008. Vol 2008. US Department of Health and Human Services; 2008:A1\u2013H14."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3181f7d043"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_2_23_2","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","unstructured":"Centers for Disease Control and Prevention (CDC) . Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2011."},{"key":"e_1_3_2_24_2","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","author":"Centers for Disease Control and Prevention (CDC)","year":"2013","unstructured":"Centers for Disease Control and Prevention (CDC) . Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2013."},{"key":"e_1_3_2_25_2","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","author":"Centers for Disease Control and Prevention (CDC)","year":"2015","unstructured":"Centers for Disease Control and Prevention (CDC) . Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2015."},{"key":"e_1_3_2_26_2","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","author":"Centers for Disease Control and Prevention (CDC)","year":"2017","unstructured":"Centers for Disease Control and Prevention (CDC) . Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2017."},{"key":"e_1_3_2_27_2","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","author":"Centers for Disease Control and Prevention (CDC)","year":"2019","unstructured":"Centers for Disease Control and Prevention (CDC) . Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2019."},{"key":"e_1_3_2_28_2","unstructured":"Weighting calculated variables in the 2021 data file of the behavioral risk factor surveillance system."},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-019-0797-2"},{"key":"e_1_3_2_31_2","first-page":"1209","article-title":"Prevalence of regular physical activity among adults\u2014United States, 2001 and 2005","volume":"56","author":"Kruger J","year":"2008","unstructured":"Kruger J, Kohl HW III, Miles IJ. Prevalence of regular physical activity among adults\u2014United States, 2001 and 2005. JAMA. 2008;56:1209\u20131212.","journal-title":"JAMA"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.10.015"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-11-7"},{"key":"e_1_3_2_34_2","first-page":"A17","article-title":"PEER REVIEWED: prevalence of physical activity in the United States: Behavioral Risk Factor Surveillance System, 2001","volume":"2","author":"Macera CA","year":"2005","unstructured":"Macera CA, Ham SA, Yore MM, Jones DA, Kimsey CD, Kohl HW III, Ainsworth BE III. PEER REVIEWED: prevalence of physical activity in the United States: Behavioral Risk Factor Surveillance System, 2001. Prev Chronic Dis. 2005;2:A17.","journal-title":"Prev Chronic Dis"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001148"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000435708.67487.da"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000350"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000022"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-018-0328-1"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2016.46.3.394"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/15412550701480489"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.086"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106641"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/sjop.12190"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.08.012"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-010-0204-4"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-5-56"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.041189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:57:56Z","timestamp":1753876676000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.041189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":46,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1161\/JAHA.124.041189"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.041189","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e041189"}}