The Feasibility and Longitudinal Effects of a Home-Based Sedentary Behavior Change Intervention After Stroke

Abstract

Objective To evaluate the feasibility and preliminary effects of a sedentary behavior change intervention on sedentary behavior, physical activity, function, and quality of life following inpatient stroke rehabilitation.Design Single-group, longitudinal, intervention study with 1-week baseline, 8-week intervention, and 8-week follow-up.Setting Community.Participants Individuals (N=34) with subacute stroke recruited within 1 month following discharge home from inpatient stroke rehabilitation.Intervention STand Up Frequently From Stroke (STUFFS) intervention that involved interrupting and replacing sedentary time with upright activities (standing and walking) at home and in the community. A motivational wrist-worn activity monitor was used throughout the intervention.Main outcome measures Primary outcomes were reach (enrolled/eligible), retention (completed/enrolled), satisfaction, and compliance with the intervention. Secondary outcomes were sedentary behavior, physical activity, lower extremity impairment, self-efficacy, cognitive status, mobility, and quality of life outcomes.Results Forty-four participants were eligible to participate. Of the eligible, 34 (77.3%; time since stroke onset: 3.5±1.1 months) were enrolled at baseline and 32 (94.1%) of the enrolled had complete data at follow-up. Satisfaction with the program was 89%. Sedentary time decreased by 54.2±13.7 minutes per day (P<.01) at postintervention and 26.8±14.0 minutes per day (P=.07) at follow-up, relative to baseline. There were significant improvements in walking speed, cognition, impairment, and self-reported quality of life over time (P<.05). Self-efficacy was high across all time points. The number of steps and time spent stepping were not statistically different across both time periods.Conclusions The program was feasible to deliver in the home environment with good retention and satisfaction. Further research is required to test the effectiveness of the STUFFS program compared with usual care.