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BACKGROUND: The relationship between pre- and post-stroke physical activity levels is underexplored. OBJECTIVE: To determine whether self-reported physical activity changes from pre-stroke to two years post-stroke; and to explore the relationship between self-reported and objectively measured physical activity post-stroke. METHODS: Stroke survivors admitted to rehabilitation were included in this observational study. Participants were assessed at rehabilitation discharge (five months post-stroke) and two years later. Participants were asked about their pre-stroke and current activity levels. The Sensewear Armband was worn for one week to measure physical activity at each timepoint. The relationship between self-reported and objectively measured physical activity was explored with Spearman correlation coefficients and multiple regression models. RESULTS: Sixty-eight stroke survivors (65% male, mean age 64) participated at baseline. Fifty participants reported undertaking physical activity pre-stroke, and 48 of these active participants reported undertaking physical activity two years post-stroke. At two years one third of the active participants reported doing the same type of activity (primarily walking). Approximately one third reported doing the same type of activity and more and approximately one third had to modify the type of activity undertaken. Self-reporting of physical activity time was positively correlated with objective measures of physical activity at two years (r = 0.61, p<0.001). Objectively measured physical activity, age, and sex predicted 26.5% of the variance in self-reported physical activity (p<0.001). CONCLUSION: In this single-site study of relatively able participants, stroke survivors frequently returned to their pre-stroke types of physical activity. A positive correlation between self-reported and objective measures of physical activity was demonstrated, but self-reported activity overestimates objective physical activity post-stroke.

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BACKGROUND AND PURPOSE: Government and professional organizations around the world have issued a call for evidence-based practice (EBP), affecting nursing globally. This study aimed to establish a baseline measure of EBP knowledge in French-speaking, baccalaureate nursing students and test the psychometric performance of a newly translated instrument. METHODS: For the cross-sectional, descriptive, correlational study, 103 baccalaureate nursing students from Haiti were included in the analysis. RESULTS: Rasch analysis showed strong evidence of validity (Weighted MS M = 984; Unweighted MS M = 1.01). Individual items showed item reliability (.94). The mean EBP knowledge score was 5.9 (SD = 1.93; Range = 2-10 points). CONCLUSIONS: This study provides initial psychometric evidence for an EBP knowledge measure that can be used as a catalyst for research in 29 French-speaking countries.

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BACKGROUND: Government and professional organizations have issued a call for evidence-based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians. AIMS: This study sought to translate the Evidence-based Practice Knowledge Assessment in Nursing (EKAN) instrument into Spanish, evaluate the psychometric performance of the newly translated instrument, and establish a baseline measure of EBP knowledge of baccalaureate nursing (BSN) students for future program improvement. METHODS: This study utilized a cross-sectional, descriptive, correlational design. A total of 139 BSN students were recruited from a single study site in the Dominican Republic. Subjects completed the 20-item EKAN-Spanish, which was translated and back-translated to promote semantic accuracy. RESULTS AND FINDINGS: Infit and outfit statistics for the sample centered around 1.0 (weighted mean square = 0.978; unweighted mean square = 0.988), indicating strong evidence of validity. The individual items on the EKAN-Spanish showed item reliability of 0.94. The mean EBP knowledge score was 6.52 (SD = 2.03) with scores ranging from 2 to 12 points (20 points maximum). Differential item functioning (DIF) analysis supported translational accuracy. DISCUSSION: This study provides validation support for an objective assessment of EBP knowledge in the Spanish language and will be useful for future studies of EBP in over 21 Spanish-speaking countries. LINKING EVIDENCE TO ACTION: While EBP is a global nursing concept, there has been no instrument to objectively measure EBP knowledge across levels of education in academe and practice in Spanish-speaking countries until just recently. The availability of a validated instrument will promote global consistency in assessing EBP knowledge. Further, this will promote a collaborative approach in teaching EBP to nursing students and practicing nurses.

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BACKGROUND: To examine the level of physical activity and sedentary behavior (SB), measured with accelerometers, in older adults from a city in southern Brazil according to sociodemographic and health characteristics. METHODS: The sample consisted of 425 older adults (≥63 y) from the EpiFloripa Aging Study. Light physical activity (LPA), moderate to vigorous physical activity (MVPA), and SB were measured with accelerometers over a period of 7 days. RESULTS: The older adults spent two-thirds of the time of use in SB, one-third in LPA, and only 2.1% (95% confidence interval, 1.8-2.2) in MVPA. In the final adjusted model, lower levels of MVPA were observed for women, as well as higher SB and lower LPA and MVPA for those with higher age. There were also trends toward prolonged SB and lower LPA when participants had a higher educational level and toward lower MVPA with higher body mass index. CONCLUSIONS: Constant monitoring of physical activity levels and SB using objective measures is recommended and interventions should be directed at the groups most exposed to excessive SB and low levels of MVPA.

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Background: Wearable monitors (WMs) are used to estimate the time spent in sedentary behaviors (SBs) and light-intensity physical activities (LPAs) and their associated energy cost; however, the accuracy of WMs in measuring behaviors on the lower end of the intensity spectrum is unclear. The aim of this study was to assess the validity of 3 WMs (ActiGraph GT3X+; activPAL, and SenseWear 2) in estimating the intensity of SB and LPA in adults as compared with the criterion measure of oxygen uptake (VO2) measured by indirect calorimetry. Methods: Sixteen participants (age: 25.38 ± 8.58 years) wore the ActiGraph GT3X+, activPAL, and SenseWear 2 devices during 7 sedentary-to-light activities. VO2 (mL/kg/min) was estimated by means of a portable gas analyzer, Oxycon Mobile (Carefusion, Yorba Linda, CA, USA). All data were transformed into metabolic equivalents and analyzed using mean percentage error, equivalence plots, Bland-Altman plots, kappa statistics, and sensitivity/specificity. Results: Mean percentage error was lowest for the activPAL for SB (14.9%) and LPA (9.3%) compared with other WMs, which were >21.2%. None of the WMs fell within the equivalency range of ±10% of the criterion mean value. Bland-Altman plots revealed narrower levels of agreement with all WMs for SB than for LPA. Kappa statistics were low for all WMs, and sensitivity and specificity varied by WM type. Conclusion: None of the WMs tested in this study were equivalent with the criterion measure (VO2) in estimating sedentary-to-light activities; however, the activPAL had greater overall accuracy in measuring SB and LPA than did the ActiGraph and SenseWear 2 monitors.