Sitting and Activity Time in People With Stroke

Background: Excessive sitting time is linked to cardiovascular disease morbidity. To date, no studies have accurately measured sitting time patterns in people with stroke.

Objective: To investigate the amount and pattern of accumulation of sitting time, physical activity and use of time in people with stroke compared to age-matched healthy peers.

Design: This study used an observational design.

Methods: Sitting time (total, and time accumulated in prolonged, unbroken bouts of ≥30mins) was measured with an activPAL3 activity monitor. Physical activity and daily energy expenditure were measured using the Actigraph GT3X+ accelerometer and SenseWear arm band respectively. All monitors had a seven-day wear protocol. Participants recalled one day of activity (during monitor wear time) using the Multimedia Activity Recall for Children and Adults.

Results: 63 adults (mean age 68.4 ± 10.0 years, 35% female) participated (n=40 stroke, n=23 age-matched healthy controls). Participants with stroke (mean 10.9[SD 2.0] hours/day) spent significantly more time sitting compared to controls (8.2[2.0] hours/day), with much of this sitting time prolonged (stroke 7.4[2.8] hours/day; control 3.7[1.7] hours/day). People with stroke accumulated most of their sitting time whilst watching TV and in general quiet time, while control participants spent more time reading and on the computer. Physical activity (p<0.001) and daily energy expenditure (p=0.060) were lower in stroke versus control participants.

Limitations: We used a sample of convenience for stroke and control participants which may reduce the generalizability of results.

Conclusions: People with stroke spend more time sitting and less time in activity than age-matched peers. Further work is needed to determine whether reducing sitting time is feasible and leads to clinically important reductions in cardiovascular risk in this population.