Relationship Between Prolonged Sedentary Bout and Functional Recovery in Patients With Subacute Stroke: A Multicenter...

To examine the association between the daily count of sedentary bouts ≥60 minutes and activities of daily living (ADL) recovery in nonambulatory patients with subacute stroke.

A prospective observational cohort study.

Convalescent rehabilitation wards in 11 inpatient facilities across Japan.

Patients with subacute stroke admitted between February 2022 and February 2025 who were unable to walk independently at admission but had been independent in ADL before stroke onset (N = 626). A total of 588 participants were analyzed.

Not applicable.

Outcome measurement was the motor subscale of the functional independence measure assessed longitudinally at admission, 1 month after admission, and at discharge. The exposure was the mean daily count of ≥60-minute sedentary bouts measured by triaxial accelerometry during the first week after admission. Linear mixed-effects models were used to examine associations between the mean daily count of ≥60-minute sedentary bouts at admission and the motor subscale of the functional independence measure change over time, adjusting for covariates, including total sedentary time. Exploratory age-stratified analyses (≥65 vs ≤64y) were also conducted.

Higher daily count of ≥60-minute sedentary bouts was significantly associated with poorer ADL recovery (β=-1.53; 95% CI]: -2.31 to -0.76; P<.001), independent of total sedentary time. Age-stratified analyses revealed that this association was significant in older adults (β=-1.52; 95% CI: -2.46 to -0.57; P=.002) but not in younger patients (β=-0.73; 95% CI -2.05 to 0.59; P=.278).

In nonambulatory patients with subacute stroke, frequent prolonged sedentary bouts during early rehabilitation were independently associated with poorer ADL recovery, particularly in older adults. Interrupting extended sitting periods may represent a simple, low-cost intervention to support functional recovery in stroke rehabilitation.