Background: Excessive sitting time is linked to cardiovascular disease morbidity. To date, no studies have accurately measured sitting time patterns in people with stroke.Objective: The purpose of this study was to investigate the amount and pattern of accumulation of sitting time, physical activity, and use of time in people with stroke compared with age-matched healthy peers.Design: This study used an observational design.Methods: Sitting time (total and time accumulated in prolonged, unbroken bouts of ≥30 minutes) was measured with an activity monitor. Physical activity and daily energy expenditure were measured using an accelerometer and a multisensory array armband, respectively. All monitors had a 7-day wear protocol. Participants recalled 1 day of activity (during monitor wear time) using the Multimedia Activity Recall for Children and Adults.Results: Sixty-three adults (40 with stroke and 23 age-matched healthy controls) participated. The participants (35% female, 65% male) had a mean age of 68.4 years (SD=10.0). Participants with stroke spent significantly more time sitting (X̅=10.9 h/d, SD=2.0) compared with controls (X̅=8.2 h/d, SD=2.0), with much of this sitting time prolonged (stroke group: X̅=7.4 h/d, SD=2.8; control group: X̅=3.7 h/d, SD=1.7). Participants with stroke accumulated most of their sitting time while watching television and in general quiet time, whereas control participants spent more time reading and on the computer. Physical activity and daily energy expenditure were lower in the stroke group compared with the control group.Limitations: A sample of convenience was used to select participants for the stroke and control groups, which may reduce the generalizability of results.Conclusions: Participants with stroke spent more time sitting and less time in activity than their age-matched peers. Further work is needed to determine whether reducing sitting time is feasible and leads to clinically important reductions in cardiovascular risk in this population.

Objective: To systematically review evidence for the reliability of real-time brightness-mode ultrasound for assessing skeletal muscle size in human limbs in vivo and to establish in which populations and anatomical sites the reliability had been tested. Data sources: Articles were retrieved via electronic database searching and expert contact. Study selection: Studies reporting reliability indices of test–retest measures of real-time brightness-mode ultrasound measures of skeletal muscle size within human limbs were included. Data extraction: Articles were assessed for methodological quality by two reviewers, decisions were made by consensus. Participant characteristics, measurement protocol, ultrasound protocol, type of reliability measured and statistical methods were extracted by one reviewer. Data synthesis: Twenty-four articles were included, involving 605 participants. Studies were of low to moderate methodological quality. Most studies were conducted within the healthy population. Only one study demonstrated poor reliability at one site only, and only when the participants were measured in the supine position. Conclusion: There is a moderate amount of low-level evidence that real-time brightness-mode ultrasound has good reliability for measuring muscle size across a number of limb sites in healthy populations. There is limited evidence for the reliability of ultrasound measures of muscle size in clinical populations.

Understanding factors that influence the amount of time people with stroke spend sitting and being active is important to inform the development of targeted interventions. To explore the physical, cognitive, and psychosocial factors associated with daily sitting time and physical activity in people with stroke. Secondary analysis of an observational study (n = 50, mean age 67.2 ± 11.6 years, 33 men) of adults at least 6 months post-stroke. Activity monitor data were collected via a 7-day, continuous wear (24 hours/day) protocol. Sitting time [total, and prolonged (time in bouts of ≥ 30 minutes)] was measured with an activPAL3 activity monitor. A hip-worn Actigraph GT3X+ accelerometer was used to measure moderate-to-vigorous-intensity physical activity (MVPA) time. Univariate analyses examined relationships of stroke severity (National Institutes of Health Stroke Scale), physical [walking speed, Stroke Impact Scale (SIS) physical domain score], cognitive (Montreal Cognitive Assessment), and psychosocial factors (living arrangement, SIS emotional domain score) with sitting time, prolonged sitting time, and MVPA. Self-reported physical function and walking speed were negatively associated with total sitting time (r = − 0.354, P = 0.022 and r = − 0.361, P = 0.011, respectively) and prolonged sitting time (r = − 0.5, P = 0.001 and − 0.45, P = 0.001, respectively), and positively associated with MVPA (r = 0.469, P = 0.002 and 0.431, P = 0.003, respectively). Physical factors, such as walking ability, may influence sitting and activity time in people with stroke, yet much of the variance in daily sitting time remains unexplained. Large prospective studies are required to understand the drivers of activity and sitting time.