Abstract
Objective
To quantify longitudinal changes in sedentary behavior (ie, nonexercise seated or
lying behavior) after stroke to ascertain whether reducing sedentary behavior might
be a new therapeutic target.
Design
Longitudinal cohort study of patients with acute stroke who were followed over 1 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, 72y, interquartile
range [IQR]=64–80y; 67% men; median National Institute of Health Stroke Scale score=2,
IQR=1–3) who were assessed at 1, 6, and 12 months after stroke.
Interventions
Not applicable.
Main Outcome Measures
Objective measures of amount and pattern of time spent in sedentary behavior: total
sedentary time, weighted median sedentary bout length, and fragmentation index.
Results
Stroke survivors were highly sedentary, spending on average 81% of the time per day
in sedentary behavior: median=19.9 hours (IQR=18.4–22.1h), 19.1 hours (17.8–20.8h),
and 19.3 hours (17.3–20.9h) at 1, 6, and 12 months, respectively. Longitudinal changes
in sedentary behavior were estimated using linear mixed effects models. Covariates
were age, sex, stroke severity (National Institute of Health Stroke Scale score),
physical capacity (6-minute walk distance), and functional independence (Nottingham
Extended Activities of Daily Living Questionnaire score). Higher stroke severity and
less functional independence were associated cross-sectionally with more sedentary
behavior (β=.11, SE=.05, P=.020 and β=−.11, SE=.01, P<.001, respectively). Importantly, the pattern of sedentary behavior did not change
over the first year after 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 behavior
might be a potential new therapeutic target in stroke rehabilitation.
Keywords
List of Abbreviations:
IQR (interquartile range), 6MWT (6-minute walk test), NEADL (Nottingham Extended Activities of Daily Living Questionnaire), NIHSS (National Institute of Health Stroke Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 14, 2014
Footnotes
Supported by the Edinburgh and Lothian Health Foundation (grant no. 49-49), the Chief Scientist Office of the Scottish Government (The Edinburgh Fatigue after Stroke study; grant no. CZG/2/387), the Biotechnology and Biological Sciences Research Council, the Engineering and Physical Sciences Research Council, the Economic and Social Research Council, and the Medical Research Council.
Disclosures: M. Allerhand, G. Mead, and Z. Tieges are members of the University of Edinburgh Center for Cognitive Ageing and Cognitive Epidemiology, part of the cross-council Lifelong Health and Wellbeing Initiative. The other authors have nothing to disclose.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
