1453 - Quantifying Different Dimensions of Daily Physical Activity and Sedentary Behavior Post-Stroke

Objectives:

Background: Physical activity post-stroke is a broad construct, with distinct variables quantifying different dimensions of activity. Daily steps are strongly linked to overall health outcomes, while walking cadence and sedentary behavior are significantly associated with cardiovascular health. The relationship between these variables is poorly understood, limiting our ability to design targeted interventions to improve physical activity and health outcomes post-stroke.

Objectives: To describe the relationship between daily steps, average bout cadence (steps/minute), and long sedentary bouts (≥30 inactive minutes), and explore predictors of bout cadence and long sedentary bouts in community-dwelling adults post-stroke.

Design:

Methods: Secondary analysis using baseline data (14 days) from individuals enrolled in a clinical trial. Daily steps, average bout cadence, and long sedentary bouts were obtained from a Fitbit wearable device. We explored the relationship between these variables and daily steps using Spearman’s Rank Correlation and examined predictors of these physical activity metrics using linear mixed effects regression.

Results:

Results: Fifty-nine participants with a mean (SD) age of 57.1 (14.2) years and a median [IQR] 16 [15] months post-stroke. Participants achieved 5598 [5889] median steps/day, with an average bout cadence of 26.9 (9.8) steps/min and 8.4 (3.2) long sedentary bouts/day. There was a significant (P< 0.001) relationship between daily steps and average bout cadence (ρ=0.78) and long sedentary bouts (ρ=-0.26). Average bout cadence significantly decreased (P< 0.05) for female, relative to male, participants (-5.29 steps/min, 95% CI [-8.3, -2.2]), with higher socioeconomic deprivation (-4.24 steps/min, [-8.1, -0.4]), higher BMI (-0.32 steps/min, [-0.04, -0.02]), and with greater depression symptoms (-0.65 steps/min, [-0.07, -0.03]). We found no significant predictors of long sedentary bouts.

Conclusions:

Conclusion: These results can inform the development of novel, targeted interventions to improve physical activity post-stroke. Interventions to increase daily steps may also improve bout cadence and decrease long sedentary bouts but further investigation is needed.