Limitations
prestroke, stroke, mild-to-moderate stroke
STROKE
This study has several limitations. First, there was a high proportion of participants with mild stroke, which may limit the generalizability of the findings to populations with mild-to-moderate stroke severity. This situation may also limit the ability to replicate the study findings. Second, although group-based trajectory is an emerging statistical method in research, the analysis was able to identify only 2 trajectory groups (increaser and decreaser) in this study, which may indicate that the patient group was rather homogenous. Furthermore, we may have lost information on patients with fluctuating physical activity levels since they were stratified in either the increaser or decreaser group. Third, multiple factors with several dimensions were included; however, due to limited sample size, there may be confounding factors that were not included in this study, such as body mass index, diet, prestroke physical activity level, and recurrent stroke. Fourth, although we documented participants’ physical training with a physiotherapist, an occupational therapist, or on their own, almost all individuals had a combination of training types. Consequently, it was not possible to separate the outcomes from the different types of training in any meaningful way to fully evaluate their impact. Fifth, SGPALS was rated through interviews using standardized questions, which might be prone to recall and emotional bias.