Effects of Sit-to-stand Exercise Instruction and Goal-setting on Reducing Sitting Time in Chronic Stroke Survivors: A...

This study compared the effects of sit-to-stand exercise instruction (STS instruction) and participant-led goal-setting on sedentary behavior in chronic stroke survivors with reduced walking ability. We hypothesized that STS instruction would reduce prolonged sitting bouts more effectively than goal-setting.

Twelve chronic stroke survivors completed a randomized crossover trial consisting of two 2-week interventions (STS instruction and participant-led goal-setting) separated by a 1-month washout. Physical activity time was measured using a thigh-worn activPAL4 accelerometer. The primary outcomes were the number and total duration of prolonged sitting bouts ≥30 min. Secondary outcomes included total sitting/lying time, standing/walking time, sit-to-stand transitions, and prolonged sitting bouts ≥60 min.

A significant intervention × time interaction was observed for prolonged sitting bouts ≥30 min (p = 0.049), with different pre-post patterns between intervention phases (STS: 8.4-7.0/day; goal-setting: 8.1-9.3/day). The interaction for the total duration of ≥30-min bouts was not statistically significant (p = 0.156). No significant intervention × time interactions were observed for total sedentary time, standing/walking time, or for the number or total duration of sitting bouts ≥60 min.

STS instruction may contribute to modifying sitting patterns in chronic stroke survivors with limited walking ability, even without changes in total sedentary or upright time. These preliminary findings suggest that a simple, task-oriented approach may help modify sedentary patterns, although clear superiority over participant-led goal-setting was not demonstrated. Larger and longer-term trials are needed.