Sedentary behaviour in stroke survivors with severe mobility disability living at home: An exploratory study

Background: As the detrimental effects of sedentary behaviour on health and well-being are well documented and with stroke survivors having an increased risk of poor health outcomes and being identified as being more sedentary than healthy adults (English et al., 2014), it was deemed important to address the gap in sedentary behaviour and stroke research by focusing on those stroke survivors who have severe mobility disability. The thesis aimed to investigate and better understand sedentary behaviour in stroke survivors with severe mobility disability living at home and identify the next steps needed for research into sedentary behaviour in this stroke population. Methods: Two systematic reviews were undertaken to evaluate the existing literature. A Q-methodological study was conducted to explore sedentary behaviour from the perspectives of stroke survivors who have severe mobility disability, their carers and healthcare professionals. A second study investigated the energy requirements for activities of daily living in stroke survivors with severe mobility disability living at home using indirect calorimetry. Results: Keeping moving and reducing sedentary behaviour following their stroke was an integral part of their rehabilitation, with an intervention and strategies to reduce sedentary behaviour in this stroke population being welcomed by the stroke survivors, carers and healthcare professionals involved in their care. The thesis also identified higher energy requirements for activities of daily living in stroke survivors with severe mobility disability compared to healthy adults and that it may be possible to incorporate seated functional tasks involving the upper limb in strategies to reduce sedentary behaviour. Conclusions: The novel research presented in the thesis highlights the importance of inclusion of stroke survivors with severe mobility disability in research and the need for further research to build upon the baseline provided by the thesis in order to inform future interventions to reduce sedentary behaviour in this stroke population.