Effect of Rehabilitation Exercise Amount on Sleep Quality in Patients with Stroke

Objective: Patients with stroke often have accompanying sleep disorders. However, sleep quality plays a crucial role in motor function recovery and brain reorganization. Improving sleep disorders is therefore of great clinical importance. Studies have shown that exercise and increased physical activity have positive effects on sleep disorders and sleep quality. However, studies supporting the use of rehabilitation exercise to achieve a similar effect on sleep quality in patients with stroke are still limited. Therefore, in this study, actigraphy was used to analyze the relationship between the amount and intensity of rehabilitation exercise and sleep. This study contributes to understanding regarding the effects of rehabilitation exercise on sleep quality in patients with stroke. Methods:An observational study was conducted to investigate the correlation between the amount and intensity of rehabilitation exercise in patients with stroke and their sleep quality. Results: We observed a positive correlation between moderate- and high-intensity exercise duration and sleep efficiency, but only the correlation between high-intensity exercise duration and sleep efficiency was significant (p≦0.001). We found a negative correlation between high-, moderate-, and low-intensity exercise duration and real sleep time. However, only low-intensity exercise duration was significantly correlated with real sleep time (p≦0.001). We also observed a significant negative correlation between high- (p≦0.001), moderate- (p≦0.001), and low-intensity (p = 0.008) exercise duration and total sleep time. Almost no significant correlation was noted between adjustment factors (gender, age, stroke type, and motor disability severity) and sleep efficiency; we only noted a significant negative correlation between left-sided strokes and sleep efficiency (p = 0.001). Conclusions: High-intensity rehabilitation exercise had a significant positive effect on sleep efficiency in the observed patients with stroke. Rehabilitation exercise, regardless of its intensity, could reduce required sleep time in the patients with stroke. Furthermore, we recommend instructing patients to engage in not only rehabilitation exercise, but specifically, moderate- or high-intensity rehabilitation exercise, because only such exercise could effectively improve patients’ sleep quality.