Original research
Characterizing Energy Expenditure During Sedentary Behavior After Stroke

https://doi.org/10.1016/j.apmr.2015.09.006Get rights and content

Abstract

Objectives

To measure and calculate the energy expended by people with stroke during near sedentary behaviors (lying, supported and unsupported sitting, standing, wheelchair propulsion, walking), under controlled laboratory conditions, and to compare these values with the energy expenditure of 1.5 metabolic equivalent task (MET) within the definition of sedentary behavior.

Design

Cross-sectional cohort study.

Setting

Rehabilitation institutions.

Participants

People with stroke (N=27; mean age, 61.0±11.7y), categorized at Functional Ambulation Categories (FAC) 0 to 5.

Interventions

Not applicable.

Main Outcome Measures

Energy expenditure (measured using indirect calorimetry) expressed in METs. The recorded values were calculated for every participant and averaged for each activity: lying, supported and unsupported sitting, standing, wheelchair propulsion, and walking. Calculations were done for the total group and categorized by the FAC.

Results

For the total group the mean METs ± SDs were 1.04±.11 for sitting supported, 1.09±.15 for sitting unsupported, 1.31±.25 for standing, 1.91±.42 for wheelchair propulsion, and 2.52±.55 for walking. People with stroke in all FAC had METs values >1.5 when propelling a wheelchair or walking.

Conclusions

Energy expenditure during typical sedentary behaviors (ie, sitting) is narrowly bounded at approximately 1.0 MET. Energy expenditure during sitting and standing was ≤1.5 MET for all FAC, with the exception of FAC 0 (1.6 MET during standing). Independent wheelchair propulsion and walking can be categorized as light activities (≥1.5 MET).

Section snippets

Design and participants

This cross-sectional observational study was conducted in 2 rehabilitation institutions from the Stroke Service University Medical Center Utrecht. The Institutional Review Board of the University Medical Center Utrecht approved the study. The medical ethics committees of the 2 participating institutes approved the study, and informed consent was obtained from all included patients.

Participants were selected from an inpatient and outpatient stroke rehabilitation program. They all had a first or

Participant characteristics

Thirty-one eligible participants were invited to participate; of these, 29 agreed and gave informed consent. Subsequently, 1 person could not participate because he was unable to attend the assessments, and 1 person was excluded because it was not possible to measure resting metabolism during lying. Therefore, 27 participants were included in the analysis. Their mean age was 61.0 years, and 77.8% of the participants had had an ischemic stroke.

During the measurements, 1 participant who was

Discussion

This observational study shows that energy expenditure during sitting and standing was ≤1.5 MET for patients in all FAC, with the exception of patients with the lowest ambulation category, FAC 0 (1.6 MET during standing). The findings demonstrated that the energy expenditure during typical sedentary behaviors (sitting supported and unsupported) is very narrowly bounded around 1 MET. It has been suggested that sedentary behavior is defined by activities expending ≤1.5 MET. In this study, people

Conclusions

The findings of this study demonstrate that the energy expenditure during typical sedentary behaviors (sitting supported and unsupported) for people with stroke is very narrowly bounded at approximately 1.0 MET. Energy expenditure during sitting and standing was ≤1.5 MET for all FAC, with the exception of FAC 0 (1.6 MET during standing). Independent wheelchair propulsion and walking seem to be light activities (≥1.5 MET) that could be used by people with stroke to interrupt sedentary behavior.

Suppliers

  • a.

    METAMAX and MetaSoft version 2.6; Cortex Medical.

  • b.

    SPSS version 21.0; SPSS.

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  • Disclosures: none.

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