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Use of Accelerometers to Examine Sedentary Time on an Acute Stroke Unit.

ABSTRACT: Observational studies demonstrate low levels of physical activity during inpatient stroke rehabilitation. There are no prior studies that have objectively measured sedentary time on the acute stroke unit and whether sedentary time is related to functional outcomes. The purpose of this study was to characterize sedentary time after acute stroke and determine whether there is a relationship to functional performance at discharge.Thirty-two individuals (18 men; 56.5 ± 12.7 years) with acute stroke were enrolled within 48 hours of hospital admission. An accelerometer was placed on the stroke-affected ankle to measure 24-hour activity and was worn for 4 days or until discharge from the hospital. Performance of activities of daily living, walking endurance, and functional mobility were assessed using the Physical Performance Test, Six-Minute Walk Test, and Timed Up and Go, respectively.Mean percent time spent sedentary was 93.9 ± 4.1% and percent time in light activity was 5.1 ± 2.4%. When controlling for baseline performance, the mean time spent sedentary per day was significantly related to Physical Performance Test performance at discharge (r = -0.37; P = .05), but not the Six-Minute Walk Test or Timed Up and Go.Patients with acute stroke were sedentary most of their hospital stay. To minimize the potential negative effects of inactivity, our data suggest that there should be greater emphasis on increasing physical activity during the hospital stay.Video Abstract Available for more insights from the authors (Supplemental Digital Content 1, http://links.lww.com/JNPT/A101).

SUBMITTER: Mattlage AE

PROVIDER: S-EPMC4470858 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Use of Accelerometers to Examine Sedentary Time on an Acute Stroke Unit.

Mattlage Anna E AE Redlin Sara A SA Rippee Michael A MA Abraham Michael G MG Rymer Marilyn M MM Billinger Sandra A SA

Journal of neurologic physical therapy : JNPT 20150701 3

<h4>Background and purpose</h4>Observational studies demonstrate low levels of physical activity during inpatient stroke rehabilitation. There are no prior studies that have objectively measured sedentary time on the acute stroke unit and whether sedentary time is related to functional outcomes. The purpose of this study was to characterize sedentary time after acute stroke and determine whether there is a relationship to functional performance at discharge.<h4>Methods</h4>Thirty-two individuals ...[more]

PMID: 26035120

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Project description:Background: The time adults spend sitting in front of screens is a health risk factor. In contrast, walking and cycling to and from work, also known as active commuting, could promote physical activity and improve population health. Objective: This study investigated automatic properties role in explaining active commuting and screen-based sedentary behaviours. The stable, daily conditions for carrying out active commuting and screen-based sedentary behaviour are most likely to develop automatic properties. These characteristics mean performing behaviours via external cues (i.e. lack of intentionality), with an unpleasant emotional experience of not carrying out a set routine (i.e. lack of controllability), and without paying much attention (i.e. efficiency). Method: This article describes findings of a prospective and correlational study in which 128 people participated. First, participants responded to questions assessed using the Generic Multifaceted Automaticity Scale (GMAS), which measured the automatic properties of screen-based sedentary behaviour and active commuting. The following week, both behaviours were assessed by daily logs to document active commuting and screen-based sedentary behaviour events, and by an accelerometer, worn for seven days, as an objective criterion. Confirmatory factor analyses, bivariate correlations, and multiple linear regressions were computed for the associations between the GMAS scores and objective criterion measures of screen-based sedentary behaviours and active commuting. Results: Automaticity facets displayed different relationships with screen-based sedentary behaviours and active commuting - people with higher lack of intentionality and lack of controllability for active commuting present higher levels of moderate physical activity. In contrast, the lack of controllability of screen-based sedentary behaviours was a significant predictor of sedentary screen time. Conclusions: The multidimensional approach to automaticity could be useful in determining more precisely the features that need to be addressed to promote the adoption of active commuting and limit the time spent sitting in front of screens.

Project description:ImportanceThe amount and intensity of physical activity required to prevent stroke are yet to be fully determined because of previous reliance on self-reporting measures. Furthermore, the association between objectively measured time spent being sedentary as an independent risk factor for stroke is unknown.ObjectiveTo investigate the associations of accelerometer-measured sedentary time and physical activity of varying intensity and duration with the risk of incident stroke.Design, setting, and participantsThis cohort study involved participants who were enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study from February 5, 2003, to October 30, 2007. Accelerometer data were collected from 7607 Black and White adults 45 years or older in the contiguous US between May 12, 2009, and January 5, 2013. Data on other races and ethnicities were not collected for scientific and clinical reasons. By design, Black adults and residents of the southeastern US stroke belt and stroke buckle were oversampled. Data were analyzed from May 5, 2020, to November 11, 2021.ExposuresSedentary time, light-intensity physical activity (LIPA), and moderate- to vigorous-intensity physical activity (MVPA) were measured using a hip-mounted accelerometer worn for 7 consecutive days and stratified by tertile for the analyses.Main outcomes and measuresIncident stroke.ResultsAmong 7607 participants, the mean (SD) age was 63.4 (8.5) years; 4145 participants (54.5%) were female, 2407 (31.6%) were Black, and 5200 (68.4%) were White. A total of 2523 participants (33.2%) resided in the stroke belt, and 1638 (21.5%) resided in the stroke buckle. Over a mean (SD) of 7.4 (2.5) years of follow-up, 286 incident stroke cases (244 ischemic [85.3%]) occurred. The fully adjusted hazard ratios (HRs) for incident stroke in the highest tertile compared with the lowest tertile were 0.74 (95% CI, 0.53-1.04; P = .08) for LIPA and 0.57 (95% CI, 0.38-0.84; P = .004) for MVPA. Higher sedentary time was associated with a 44% greater risk of incident stroke (HR, 1.44; 95% CI, 0.99-2.07; P = .04). When comparing the highest with the lowest tertile, mean sedentary bout duration was associated with a significantly greater risk of incident stroke (HR, 1.53; 95% CI, 1.10-2.12; P = .008). After adjustment for sedentary time, the highest tertile of unbouted MVPA (shorter bouts [1-9 minutes]) was associated with a significantly lower risk of incident stroke compared with the lowest tertile (HR, 0.62; 95% CI, 0.41-0.94; P = .02); however, bouted MVPA (longer bouts [at least 10 minutes]) was not (HR, 0.78; 95% CI, 0.53-1.15; P = .17). When expressed as continuous variables, sedentary time was positively associated with incident stroke risk (HR per 1-hour/day increase in sedentary time: 1.14; 95% CI, 1.02-1.28; P = .02), and LIPA was negatively associated with incident stroke risk (HR per 1-hour/day increase in LIPA: 0.86; 95% CI, 0.77-0.97; P = .02).Conclusions and relevanceIn this cohort study, objectively measured LIPA, MVPA, and sedentary time were significantly and independently associated with incident stroke risk. Longer sedentary bout duration was also independently associated with an increased risk of incident stroke. These findings suggest that replacing sedentary time with LIPA, or even very short bouts of MVPA, may lower stroke risk, supporting the concept of moving more and sitting less as a beneficial stroke risk reduction strategy among adults.

Dataset Information

Use of Accelerometers to Examine Sedentary Time on an Acute Stroke Unit.

Publications

Use of Accelerometers to Examine Sedentary Time on an Acute Stroke Unit.

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