Table 1: Example relationships between neurologic conditions, noncommunicable diseases, and modifiable risk factors related to health behaviors that can be influenced by physical therapy.
Condition | Prevalence of noncommunicable disease or modifiable risk factors related to health behaviors in neurologic condition or injury | Modifiable risk factors or health behavior associated with increased risk of developing neurologic condition or injury (incidence) | Modifiable risk factors or health behavior associated with worse outcomes when one has the neurologic condition |
---|---|---|---|
Stroke | • Stroke doubles the risk of having dementia21 • 50% prevalence of sleep disorders after stroke14 |
• Sleep impairment (insomnia) increases risk by 54%18 • High amounts of physical activity reduces risk by 20-25%12 • High cholesterol is associated with increased risk 19 |
• Sedentary lifestyle may aggravate post-stroke fatigue22 • Smoking increases risk of second stroke, MI, or death17, 20 |
SCI | • 55-68% of population is overweight or obese23 • Increased risk of cardiovascular disease based on blood cholesterol values and hypertension25 • Poor sleep and sleep related breathing disorders are greater in SCI than the general population29 |
• Number of new SCI caused by falls is increasing, along with increased average age of new SCI24 | • Obesity may be associated with the development of upper extremity overuse injuries26 • Nutritional status influences pressure ulcer closure in 27 • Pain and anxiety increase risk of developing chronic health conditions 28 |
PD | • One-third less active than older adults.42 • Sleep disorders, particularly REM behavior disorder, are common 43 |
• People who are less physically active have a greater incidence of developing PD41 | • More exercise is associated with slower decline in QOL and mobility40 • Poor nutritional status is associated with poorer functional gains during rehabilitation.44 |
MS | • The prevalence of cardiovascular disease in patients over 60 years old is more than 40%.36 | • Smoking may be associated with a 50% increase in MS risk compared to non-smoking37 | • Relapse rates 2.6 times higher in MS patients with obesity, hypertension, and diabetes36 • Higher accrual of lesions in those with poor diets36 • Smoking contributes to an 80% increase in secondary-progressive MS risk37 |
TBI | • Sports-related concussions increase risk of sleep distubance32 • Elderly individuals with a history of cancer may have worse outcomes of subsequent TBI31 |
• Complex relationships exist between TBI incidence/ prevalence with substance abuse, family violence, and social determinants of health33, 34 | • Chronic smoking impairs post-TBI recovery30 |