Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial

English, Coralie; Janssen, Heidi; Crowfoot, Gary; Bourne, Josephine; Callister, Robin; Dunn, Ashlee; Oldmeadow, Christopher; Ong, Lin Kooi; Palazzi, Kerrin; Patterson, Amanda; Spratt, Neil J; Walker, F.R.; Dunstan, David W.; Bernhardt, Julie

doi:10.1177/1747493018798535

Cited by 49 publications

(62 citation statements)

References 29 publications

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“…17,18 Recent findings have also shown that breaking up prolong sedentary time with short bouts of light PA leads to clinically relevant improvements in systolic blood pressure (3-4 mmHg) in stroke survivors. 41 These findings are encouraging since this approach could be achievable for stroke survivors with limited capacity to ambulate who will find it difficult to reach recommended levels of MVPA. On the other hand, given the potential of engaging in PA among community ambulating stroke survivors, it is quintessential to understand barriers to exercise, specifically related to socio-cultural environments, values, and norms.…”

Section: Discussionmentioning

confidence: 82%

Levels and patterns of physical activity in stroke survivors with different ambulation status living in low-income areas of Cape Town, South Africa

Joseph

Rhoda

Conradsson

2020

Topics in Stroke Rehabilitation

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Background: Little is known about physical activity (PA) in people with stroke living in low-income areas. The aim of this study was to characterize and contrast the levels and patterns of PA between stroke survivors with different ambulation status living in low-income areas in Cape Town, South Africa. Methods: In this cross-sectional study, 45 community-dwelling stroke survivors living in lowincome areas in Cape Town participated. Accelerometers (Actigraph wGT3X-BT) were used to assess PA levels (vector magnitude counts and number of steps) and time spent sedentary, in light and moderate-to-vigorous PA (MVPA). Total daily PA and within-day activity patterns were compared between limited community ambulators (gait speed: <0.8 m/s) and community ambulators (gait speed: ≥0.8 m/s). Results: Limited community ambulators (n = 23) took fewer steps per day (1091 vs. 3524 steps, P < .001), spent more time sedentary (80% vs 68%, P = .002) and less time in light PA (18% vs 25%, P = .008) and MVPA (1% vs 5%, P < .001) than community ambulators (n = 22). The limited ambulation group had a consistent pattern of PA across the day without any significant variations in PA levels or intensity, whereas the unlimited ambulating group was most active in the morning followed by a gradual reduction in PA throughout the day. Conclusions: Community ambulating stroke survivors showed greater PA levels and a more variable diurnal pattern in contrast to the limited ambulation group. Different interventions may be required to assist the different groups to start engaging in health-enhancing PA.

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Section: Discussionmentioning

confidence: 82%

Levels and patterns of physical activity in stroke survivors with different ambulation status living in low-income areas of Cape Town, South Africa

Joseph

Rhoda

Conradsson

2020

Topics in Stroke Rehabilitation

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“…The rst target behaviour is to reduce total time spent sedentary (5)(6)(7)(8)(9)(10)(11)(12)14,33). The BUST-study found a statistically and clinically relevant decrease of the systolic blood pressure by interrupting sedentary behaviour every thirty minutes with a walk of three minutes (16). Therefore, the second target behaviour is to reduce time spent in sedentary behaviour accumulated in bouts over thirty minutes.…”

Section: Stage 1: Understanding the Behaviourmentioning

confidence: 99%

“…Additionally, prolonged uninterrupted sedentary time, independent of total sedentary time, is associated with poor health and elevated cardiovascular risk factors (7,(11)(12)(13)(14)(15). In people with stroke a clinical relevant decrease of blood pressure was found by reducing and interrupting sedentary behaviour (16). Decreasing sedentary behaviour could already produce health bene ts in people with stroke (6,10,14,17).…”

Section: Introductionmentioning

confidence: 99%

Selecting behaviour change techniques to reduce sedentary behaviour in people with stroke using the Behaviour Change Wheel

Wondergem

Hendrickx

Wouters

et al. 2020

Preprint

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Background: Research has shown that sedentary behaviour increases the risk of stroke, cardiovascular disease and mortality. People with stroke are highly sedentary. Therefore, reducing sedentary behaviour might reduce the risk of secondary events and death. Personalized strategies using behavioural change techniques (BCTs) directed at reducing sedentary behaviour in people with stroke are currently lacking. Therefore, the aim of this study is to systematically determine the BCTs for a behavioural change intervention, directed at reducing sedentary behaviour in community-dwelling people with stroke,.Method: To complete the stages of the Behaviour Change Wheel , information on understanding the behaviour, identifying intervention functions, identifying BCTs and modes of delivery were needed. Per stage a literature search was conducted and nominal group technique (NGT) sessions were conducted to identify BCTs. The NGT sessions were conducted with professionals working with people with stroke and international researchers working in the stroke or sedentary behaviour field. Four different patients symptom profiles, as frequently seen in clinical practice, were used by participants during the NGT sessions: : 1. no physical or cognitive impairments; profile 2. mainly cognitive impairments; profile 3. mainly physical impairments; and profile 4. both physical and cognitive impairments. Per profile participants made their choice by rating the BCTs.Results: Five BCTs should always be included: ‘goal setting’, ‘action planning’, ‘social support’, ‘problem solving’ and ‘restructuring of the social environment’. For patients without cognitive impairments, ‘self-monitoring’, ‘feedback on behaviour’, ‘information about health consequences’ and ‘goal setting on outcome’ were advised to be included, while for patients with cognitive impairments, ‘prompts/cues’, ‘graded tasks’, ‘restructuring the physical environment’ and ‘social support practical’ should be considered. Conclusion: BCTs were identified for a behavioural change intervention aiming to reduce sedentary behaviour in community-dwelling people with first-ever stroke. BCTs recommendations depend on the presence of physical and cognitive impairments, although ‘goal setting’, ‘action planning’, ‘social support’, ‘problem solving’ and ‘restructuring of the social environment’ are recommended in all people with first-ever stroke. The identified BCTs serve as the basis for further development of a personalized blended care intervention to reduce sedentary behaviour in people with stroke.

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“…Additionally, long uninterrupted sedentary bouts are related to cardiovascular risks [13]. Interrupting SB after 20 minutes has been found to have a positive influence on glucose levels in overweight people [14], and interruption after 30 minutes decreased the systolic blood pressure of stroke survivors [15], thus providing cardiovascular health benefits.…”

Section: Introductionmentioning

confidence: 99%

Movement behavior remains stable in stroke survivors within the first two months after returning home

et al. 2020

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Background and purpose The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. Methods A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts � 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. Results In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the

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Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial

Abstract: Australian and New Zealand Clinical Trials Registry http://www.anzctr.org.au ANZTR12615001189516.

Cited by 49 publications

References 29 publications

Levels and patterns of physical activity in stroke survivors with different ambulation status living in low-income areas of Cape Town, South Africa

Levels and patterns of physical activity in stroke survivors with different ambulation status living in low-income areas of Cape Town, South Africa

Selecting behaviour change techniques to reduce sedentary behaviour in people with stroke using the Behaviour Change Wheel

Movement behavior remains stable in stroke survivors within the first two months after returning home

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