title: Sedentary behavior in the first year after stroke: a longitudinal cohort study with objective measures.
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.
  
  
  METHODS
  Longitudinal cohort study of patients with acute stroke who were followed over 1 year.
  
  
  METHODS
  Acute teaching hospital or outpatient clinic, and the community after discharge.
  
  
  METHODS
  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.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors.affiliation: Geriatric Medicine, University of Edinburgh, Edinburgh, UK; Center for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. Electronic address: Zoe.Tieges@ed.ac.uk.
authors.forename: Zoë
authors.initials: Z
authors.lastname: Tieges
authors.affiliation: Geriatric Medicine, University of Edinburgh, Edinburgh, UK; Center for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Mead
authors.affiliation: Center for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Allerhand
authors.affiliation: School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Duncan
authors.affiliation: School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Frederike
authors.initials: F
authors.lastname: van Wijck
authors.affiliation: Institute for Sport, Physical Education and Health Sciences, The Moray House School of Education, University of Edinburgh, Edinburgh, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Fitzsimons
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences and MRC-ARUK Center for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Greig
authors.affiliation: School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Chastin
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D057185:Sedentary Behavior; D012737:Sex Factors; D000071939:Stroke Rehabilitation; D013997:Time Factors
keywords: Accelerometry; Ambulatory monitoring; Physical activity; Rehabilitation; Sedentary lifestyle; Stroke