Sedentary behaviour and physical activity of people with stroke in rehabilitation hospitals.

Anna Sjöholm,Julie Bernhardt,Michael Nilsson,Thomas Lindén,Monica Skarin,Leonid Churilov

doi:10.1155/2014/591897

Abstract

Background. Sedentary behaviour is associated with health risks, independent of physical activity. This study aimed to investigate patterns of sedentary behaviour and physical activity among stroke survivors in rehabilitation hospitals. Methods. Stroke survivors admitted to four Swedish hospital-based rehabilitation units were recruited ≥7 days since stroke onset and their activity was measured using behavioural mapping. Sedentary behaviour was defined as lying down or sitting supported. Results. 104 patients were observed (53% men). Participants spent an average of 74% (standard deviation, SD 21%) of the observed day in sedentary activities. Continuous sedentary bouts of ≥1 hour represented 44% (SD 32%) of the observed day. A higher proportion (30%, SD 7%) of participants were physically active between 9:00 AM and 12:30 PM, compared to the rest of the observed day (23%, SD 6%, P < 0.0005). Patients had higher odds of being physically active in the hall (odds ratio, OR 1.7, P = 0.001) than in the therapy area. Conclusions. The time stroke survivors spend in stroke rehabilitation units may not be used in the most efficient way to promote maximal recovery. Interventions to promote reduced sedentary time could help improve outcome and these should be tested in clinical trials.

Highlights

Sedentary behaviour activities with an energy expenditure of ≤1.5 metabolic equivalent units [1, 2], such as lying down or sitting) [3] is associated with a variety of health risks, regardless of physical activity levels and other traditional risk factors such as smoking and high blood pressure
Cardiovascular disease [4, 5], type 2 diabetes [6], metabolic syndrome [7], and breast cancer [8] are a few diseases connected to sedentary behaviour, which further increases all-cause mortality [4, 5, 9, 10]
In a Norwegian acute stroke unit sedentary time accounted for 77% of the day [14, 15], while the same number for Australian acute stroke units was 88% [14]

Summary

Introduction

Sedentary behaviour activities with an energy expenditure of ≤1.5 metabolic equivalent units [1, 2], such as lying down or sitting) [3] is associated with a variety of health risks, regardless of physical activity levels and other traditional risk factors such as smoking and high blood pressure. Each additional hour spent sedentary has been proposed to be associated with a progressive rise in mortality risk [4]. A recent review [12] of 24 studies demonstrated that stroke survivors on average are involved in nontherapeutic or low physical activity for as much as 76% of the day. Few of these studies, reported on sedentary behaviours, that is, time sitting or lying down. This study aimed to investigate patterns of sedentary behaviour and physical activity among stroke survivors in rehabilitation hospitals. Interventions to promote reduced sedentary time could help improve outcome and these should be tested in clinical trials

Objectives

Methods

Results

Discussion

Conclusion