Predictors of non-stepping time in people with chronic stroke

ABSTRACT

Background

Sedentary time is an independent construct from active time. Previous studies have examined variables associated with sedentary time to inform behavior change programs; however, these studies have lacked data sets that encompass potentially important domains.

Objectives

The purpose of this study was to build a more comprehensive model containing previously theorized important predictors of sedentary time and new predictors that have not been explored. We hypothesized that variables representing the domains of physical capacity, psychosocial, physical health, cognition, and environmental would be significantly related to sedentary time in individuals post-stroke.

Methods

This was a cross-sectional analysis of 280 individuals with chronic stroke. An activity monitor was used to measure sedentary (i.e. non-stepping) time. Five domains (8 predictors) were entered into a sequential linear regression model: physical capacity (6-Minute Walk Test, assistive device use), psychosocial (Activities Specific Balance Confidence Scale and Patient Health Questionnaire-9), physical health (Charlson Comorbidity Index and body mass index), cognition (Montreal Cognitive Assessment), and environmental (Area Deprivation Index).

Results

The 6-Minute Walk Test (β = −0.39, p < .001), assistive device use (β = 0.15, p = .03), Patient Health Questionnaire-9 (β = 0.16, p = .01), and body mass index (β = 0.11, p = .04) were significantly related to non-stepping time in individuals with chronic stroke. The model explained 28.5% of the variability in non-stepping time.

Conclusions

This work provides new perspective on which variables may need to be addressed in programs targeting sedentary time in stroke. Such programs should consider physical capacity, depressive symptoms, and physical health.

KEYWORDS:

• Stroke
• walking
• physical activity
• sedentary
• depression
• behavior change

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data set associated with this work is available from the corresponding author upon request.

Additional information

Funding

This work was supported by the Foundation for Physical Therapy Research Promotion of Doctoral Studies I & II Scholarships, the National Institutes of Health under grants R01HD086362 and T32HD007490-21