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Sedentary time and activity behaviors after stroke rehabilitation: changes in the first 3 months home


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Simpson, DB ORCID: 0000-0002-9386-4830, Breslin, M ORCID: 0000-0002-8135-3136, Cumming, T, de Zoete, SA, Gall, SL ORCID: 0000-0002-5138-2526, Schmidt, M ORCID: 0000-0001-9844-3296, English, C and Callisaya, ML ORCID: 0000-0003-2122-1622 2020 , 'Sedentary time and activity behaviors after stroke rehabilitation: changes in the first 3 months home' , Topics in Stroke Rehabilitation , pp. 1-10 , doi: 10.1080/10749357.2020.1783917.

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Background: Sedentary time is prevalent following stroke, limiting functional improvement, and increasing cardiovascular risk. At discharge we examined: 1) change in sedentary time and activity over the following 3 months' and 2) physical, psychological or cognitive factors predicting any change. A secondary aim examined cross-sectional associations between factors and activity at 3 months. Methods: People with stroke (n = 34) were recruited from two rehabilitation units. An activity monitor (ActivPAL3) was worn for 7 days during the first week home and 3 months later. Factors examined included physical, psychological, and cognitive function. Linear mixed models (adjusted for waking hours) were used to examine changes in sedentary time, walking, and step count over time. Interaction terms between time and each factor were added to the model to determine if they modified change over time. Linear regression was performed to determine factors cross-sectionally associated with 3-month activity. Results: ActivPAL data were available at both time points for 28 (82%) participants (mean age 69 [SD 12] years). At 3 months, participants spent 39 fewer minutes sedentary (95%CI -70,-8 p = .01), 21 minutes more walking (95%CI 2,22 p = .02) and completed 1112 additional steps/day (95%CI 268,1956 p = .01), compared to the first week home. No factors predicted change in activity. At 3 months, greater depression (β 22 mins (95%CI 8,36) p = .004) and slower gait speed (β - 43 mins 95%CI -59,-27 p ≤ 0.001) were associated with more sedentary time and less walking activity, respectively. Conclusions: Sedentary time reduced and walking activity increased between discharge home and 3 months later. Interventions targeting mood and physical function may warrant testing to reduce sedentary behavior 3 months following discharge.

Item Type: Article
Authors/Creators:Simpson, DB and Breslin, M and Cumming, T and de Zoete, SA and Gall, SL and Schmidt, M and English, C and Callisaya, ML
Keywords: sedentary time, depression, gait speed, physical activity, rehabilitation, stroke
Journal or Publication Title: Topics in Stroke Rehabilitation
Publisher: Taylor & Francis
ISSN: 1074-9357
DOI / ID Number: 10.1080/10749357.2020.1783917
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© 2020 Taylor & Francis Group, LLC. This is an Accepted Manuscript of an article published by Taylor & Francis in Topics in Stroke Rehabilitation on 24 Jun 2020, available online at:

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