Malou H J Fanchamps1,2, Digna de Kam3, Emiel M Sneekes1, Henk J Stam1, Vivian Weerdesteyn3,4, Johannes B J Bussmann1. 1. Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands. 2. Rijndam Rehabilitation, Rotterdam, The Netherlands. 3. Department of Rehabilitation, Radboud University Medical Center Donders Center for Neuroscience, Nijmegen, The Netherlands. 4. Sint Maartenskliniek Research, Nijmegen, The Netherlands.
Abstract
Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of different operationalizations of sedentary behavior on sedentary behavior outcomes (total time; way of accumulation) in people with stroke. Methods: Sedentary behavior was analyzed in 44 people with chronic stroke with an activity monitor that measured both body postures and movement intensity. It was operationalized as: (1) combining postural and intensity data; (2) using only postural data; (3) using only intensity data. For each operationalization, we quantified a set of outcomes. Repeated measures ANOVA and Bland-Altman plots were used to compare the operationalizations. Results: All sedentary behavior outcomes differed significantly between all operationalizations (p < 0.01). Bland-Altman plots showed large limits of agreement for all outcomes, showing large individual differences between operationalizations.Conclusions: Although it was neither possible nor our aim to investigate the validity of the two-component definition of sedentary behavior, our study shows that the type of operationalization of sedentary behavior significantly influences sedentary behavior outcomes in people with stroke.Implications for RehabilitationReliable assessment of sedentary behavior after stroke is important in order to provide adequate physical behavior recommendations for people with stroke.Sedentary behavior can be operationalized in terms of body posture (sitting time) or in terms of movement intensity (time <1.5 MET) or as a combination of both criteria; this study reveals that the type of operationalization affects the different outcome measures used to quantify sedentary behavior.Comparing sedentary behavior outcomes requires caution and should only be done when sedentary behavior is operationalized in the same way.
Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of different operationalizations of sedentary behavior on sedentary behavior outcomes (total time; way of accumulation) in people with stroke. Methods: Sedentary behavior was analyzed in 44 people with chronic stroke with an activity monitor that measured both body postures and movement intensity. It was operationalized as: (1) combining postural and intensity data; (2) using only postural data; (3) using only intensity data. For each operationalization, we quantified a set of outcomes. Repeated measures ANOVA and Bland-Altman plots were used to compare the operationalizations. Results: All sedentary behavior outcomes differed significantly between all operationalizations (p < 0.01). Bland-Altman plots showed large limits of agreement for all outcomes, showing large individual differences between operationalizations.Conclusions: Although it was neither possible nor our aim to investigate the validity of the two-component definition of sedentary behavior, our study shows that the type of operationalization of sedentary behavior significantly influences sedentary behavior outcomes in people with stroke.Implications for RehabilitationReliable assessment of sedentary behavior after stroke is important in order to provide adequate physical behavior recommendations for people with stroke.Sedentary behavior can be operationalized in terms of body posture (sitting time) or in terms of movement intensity (time <1.5 MET) or as a combination of both criteria; this study reveals that the type of operationalization affects the different outcome measures used to quantify sedentary behavior.Comparing sedentary behavior outcomes requires caution and should only be done when sedentary behavior is operationalized in the same way.
Authors: H E M Braakhuis; M A M Berger; G A van der Stok; J van Meeteren; V de Groot; H Beckerman; J B J Bussmann Journal: J Neuroeng Rehabil Date: 2019-08-23 Impact factor: 4.262
Authors: Roman P Kuster; Wilhelmus J A Grooten; Victoria Blom; Daniel Baumgartner; Maria Hagströmer; Örjan Ekblom Journal: Int J Environ Res Public Health Date: 2021-05-27 Impact factor: 3.390
Authors: Nathaniel S Makowski; Rudi Kobetic; Kevin M Foglyano; Lisa M Lombardo; Stephen M Selkirk; Gilles Pinault; Ronald J Triolo Journal: Am J Phys Med Rehabil Date: 2020-12 Impact factor: 3.412