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. 2025 Jan;47(2):469-477.
doi: 10.1080/09638288.2024.2341867. Epub 2024 Apr 17.

Similarities and differences in factors associated with high and low sedentary behavior after stroke: a mixed methods study

Emily A Kringle  1 , Jessica Kersey  2 , Megan A Lewis  3 , Bethany Barone Gibbs  4 , Elizabeth R Skidmore  5
Affiliations

Similarities and differences in factors associated with high and low sedentary behavior after stroke: a mixed methods study

Emily A Kringle et al. Disabil Rehabil. 2025 Jan.

Abstract

Purpose: To identify similarities and differences in factors affecting activity engagement between adults with stroke who are more and less sedentary.

Materials and methods: Data were pooled from two studies of adults with stroke (N = 36). Sedentary time was measured activPAL micro3. Participants completed activPAL interviews, which were analyzed using framework analysis. Participants were stratified into more and less sedentary groups based on activPAL data. Between-group similarities and differences were identified.

Results: Adults with stroke (mean [SD] age = 65.8 [13.6] years, stroke chronicity = 40.5 [SD = 38.3] months, 36.1% female) were more sedentary (785.5 [64.7] sedentary minutes/day) and less sedentary (583.6 [87.4] sedentary minutes/day). Those who were more sedentary: engaged in basic activities of daily living, avoided activities, received assistance from other people, and did not use strategies to overcome barriers. Those who were less sedentary: engaged in instrumental and community activities, embraced new strategies, did activities with other people, and used strategies to overcome environmental barriers.

Conclusions: Factors affecting activity engagement differed between people who are more and less sedentary. Interventions that aim to reduce post-stroke sedentary behavior should consider the: (1) types of activities, (2) role of other people, and (2) application of strategies to overcome activity and environment-related barriers.

Keywords: Free-living physical activity; environment; sedentary behavior; social support; stroke.

Plain language summary

People with lower levels of post-stroke sedentary behavior engaged in instrumental and community activities, relative to those with higher levels who primarily engaged in basic activities of daily living.Applying models of social support that emphasize doing with rather than doing for may be important for facilitating non-sedentary lifestyles.Facilitating the use of strategies to overcome environmental barriers to activities may be an important aspect of facilitating non-sedentary lifestyles.

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Conflict of interest statement

Declaration of Interest: Research reported in this publication was supported by the National Heart Lung and Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers K23HL159240, R01HD074693, and UL1TR001857. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by funding from the National Institute of Disability, Independent Living, and Rehabilitation Research under award number 90RE5018 and the University of Pittsburgh SHRS Pre-doctoral Student Award. The authors have no additional conflicts of interest to disclose.

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