Sedentary behavior in the first year after stroke: A longitudinal cohort study with objective measures

Zoe Tieges*, Gillian Mead, Mike Allerhand, Fiona Duncan, Frederike van Wijck, Claire Fitzsimons, Carolyn Greig, Sebastien Chastin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To quantify longitudinal changes in sedentary behaviour (i.e. non-exercise seated or lying behaviour) following stroke, to ascertain whether reducing sedentary behaviour might be a new therapeutic target.

DESIGN: Longitudinal cohort study of patients with acute stroke who were followed over one year.

SETTING: Acute teaching hospital or outpatient clinic, and the community after discharge.

PARTICIPANTS: A convenience sample of patients with acute stroke (N=96; median age=72 y, inter-quartile range (IQR)=64-80; 67% male; median National Institute of Health Stroke Scale (NIHSS) score=2, IQR=1-3) who were assessed at one, six and twelve months following stroke.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Objective measures of amount and pattern of time spent in sedentary behaviour: total sedentary time, weighted median sedentary bout length and fragmentation index.

RESULTS: Stroke survivors were highly sedentary, spending on average 81% per 24-h day in sedentary behaviour: median=19.9 h (IQR=18.4-22.1), 19.1 h (17.8-20.8) and 19.3 h (17.3-20.9) at one, six and twelve months, respectively. Longitudinal changes in sedentary behaviour were estimated using linear mixed effects models. Covariates were age, sex, stroke severity (NIHSS score), physical capacity (6-minute walk distance) and functional independence (Nottingham Extended Activities of Daily Living Questionnaire). Higher stroke severity and less functional independence were associated cross-sectionally with more sedentary behaviour (β=0.11, S.E.=0.05, P = 0.020 and β=-0.11, S.E.=0.01, P < 0.001, respectively). Importantly, the pattern of sedentary behaviour did not change over the first year following stroke and was independent of functional ability.

CONCLUSIONS: Stroke survivors were highly sedentary and remained so a year after stroke independently of their functional ability. Developing interventions to reduce sedentary behaviour might be a potential new therapeutic target in stroke rehabilitation.

Original languageEnglish
Pages (from-to)15–23
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number1
Early online date14 Sep 2014
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • Accelerometry
  • Ambulatory monitoring
  • Physical activity
  • Rehabilitation
  • Sedentary lifestyle
  • Stroke
  • NOTTINGHAM EXTENDED ACTIVITIES
  • DAILY LIVING SCALE
  • PHYSICAL-ACTIVITY
  • OLDER-ADULTS
  • CARDIOVASCULAR-DISEASE
  • ACTIVITY MONITOR
  • PERFORMANCE
  • HEALTH
  • ACCELEROMETER
  • METAANALYSIS

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