title: Reducing sedentary behaviour after stroke: perspectives of ambulatory individuals with stroke.
abstract: OBJECTIVE
  Understanding the determinants of sedentary behaviour (sitting or lying with low energy expenditure) in stroke survivors can enhance the development of successful behaviour change strategies. This qualitative study explored the perceptions of stroke survivors about sedentary behaviour and ways in which it can be changed.
  
  
  METHODS
  An interpretative qualitative inquiry was used with thematic analysis of interview data. Interviews were conducted using a semi-structured guide with 13 stroke survivors. Interview transcripts were analysed using thematic analysis. Self-reported sedentary time was assessed during interviews.
  
  
  RESULTS
  Four main themes emerged from the data: meaning of sedentary behaviour, reasons for sedentary behaviour, barriers and facilitators to reducing sedentary behaviour, and strategies to sit less and move more. Only 6 participants knew about sedentary behaviour, and 2 were aware of the associated health risks. Participants encountered barriers in their daily lives that affect engagement in activity including motor impairments, fatigue, cognitive problems, and lack of motivation. Using wearable technologies and action planning to reduce sedentary behaviour hold promise as behaviour change strategies.
  
  
  CONCLUSIONS
  There is limited awareness of health risks of sedentary behaviour among stroke survivors. Strategies involving self-monitoring and movement throughout the day are potential ways to reduce sedentary behaviour. Implications for Rehabilitation Reducing sedentary behaviour in ambulatory stroke survivors is dependent on a number of modifiable determinants. Planning regular interruptions in sedentary time, such as standing or walking frequently throughout waking hours, during television commercial breaks or while using the phone are some potential strategies for reducing sedentary behaviour in stroke survivors. Availability of social and professional support and self-monitoring using wearable technologies that provide real-time feedback might result in increased motivation to sit less and move more. Using alarms and devices that provide cues to action by reminding participants to sit less and move more were perceived as important.
authors.affiliation: a Department of Physical Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , AB , Canada.
authors.forename: Victor E
authors.initials: VE
authors.lastname: Ezeugwu
authors.affiliation: b Specialized Rehabilitation Outpatient Program (SROP) , Glenrose Rehabilitation Hospital , Edmonton , AB , Canada.
authors.forename: Neera
authors.initials: N
authors.lastname: Garga
authors.affiliation: a Department of Physical Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , AB , Canada.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Manns
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D020521:Stroke / Q000453:epidemiology / Q000523:psychology; D000071939:Stroke Rehabilitation / Q000379:methods / Q000523:psychology; D016138:Walking / Q000523:psychology*
keywords: Stroke; qualitative; sedentary behaviour