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The benefits of increased physical activity for stroke survivors include improved function and mental health and wellbeing. However, less than 30% achieve recommended physical activity levels, and high levels of sedentary behaviour are reported. We developed a multifaceted behavioural intervention (and accompanying implementation plan) targeting physical activity and sedentary behaviour of stroke survivors. Intervention Mapping facilitated intervention development. Step 1 involved a systematic review, focus group discussions and a review of care pathways. Step 2 identified social cognitive determinants of behavioural change and behavioural outcomes. Step 3 linked determinants of behavioural outcomes with specific behaviour change techniques (BCTs) to target behaviours of interest. Step 4 involved intervention development informed by steps 1–3. Subsequently, an implementation plan was developed (Step 5) followed by an evaluation plan (Step 6). Community and secondary care settings, North East England. Stroke survivors and healthcare professionals (HCPs) working in stroke services. Systematic review findings informed selection of nine 'promising' BCTs (e.g. problem-solving). Focus groups with stroke survivors (n = 18) and HCPs (n = 24) identified the need for an intervention delivered throughout the rehabilitation pathway, tailored to individual needs with training for HCPs delivering the intervention. Intervention delivery was considered feasible within local stroke services. The target behaviours for the intervention were levels of physical activity and sedentary behaviour in adult stroke survivors. Assessment of acceptability and usability with 11 HCPs and 21 stroke survivors/relatives identified issues with self-monitoring tools and the need for a physical activity repository of local services' and training for HCPs with feedback on intervention delivery. A feasibility study protocol was designed to evaluate the intervention. A systematic development process using intervention mapping resulted in a multi-faceted evidence- and theory-informed intervention (Physical Activity Routines After Stroke – PARAS) for delivery by community stroke rehabilitation teams. [ABSTRACT FROM AUTHOR]

The article talks about several aspects of using longitudinal trajectories and reference percentiles for participation in activities for children with disabilities. It mentions children with disabilities tend to participate less in physical activity and recreational sports compared with their peers with typical development; and participation for children with disabilities is limited by individual factors such as fear and pain, sociocultural factors like family and stigma of disability.

Across adolescence, there is a notable decline in physical activity in boys and girls. Maturational timing may be a risk factor for disengagement from physical activity and increased sedentary behaviours during adolescence. This systematic review aimed to summarise literature that examined the relationship between maturational timing, physical activity and sedentary behaviour in adolescents. Six electronic databases were searched for articles that assessed biological maturation and physical activity (including sports participation and active transportation) or sedentary behaviours in adolescents. Two reviewers conducted title, abstract, and full-text screening, reference and forward citation searches. Included articles were evaluated for quality using a standardised tool. A narrative synthesis was used to analyse the findings due to the heterogeneity of the studies. Searches yielded 78 articles (64 unique studies) that met the inclusion criteria, representing 242,316 participants (153,179 unique). Studies ranged from 30.0% (low) to 91.7% (high) in quality. An inverse relationship between maturational timing and physical activity (in 50 and 60% of studies in boys and girls, respectively) and a positive relationship between maturational timing and sedentary behaviour (in 100% and 53% of studies in boys and girls, respectively) was most commonly reported. Evidence supporting an association between maturational timing, sports participation, and active transportation was inconsistent. While this review demonstrates some evidence for early maturational timing as a risk factor for disengagement from physical activity and increase in sedentary behaviours, the reviewed literature also demonstrates that this relationship is complex. Future research that tracks maturity-related variations in physical activity and sedentary behaviours over adolescence is warranted. [ABSTRACT FROM AUTHOR]

Background: High levels of sedentary time increases the risk of cardiovascular disease, including recurrent stroke. Objective: This study aimed to identify factors associated with high sedentary time in community-dwelling people with stroke. Methods: For this data pooling study, authors of published and ongoing trials that collected sedentary time data, using the activPAL monitor, in community-dwelling people with stroke were invited to contribute their raw data. The data was reprocessed, algorithms were created to identify sleep-wake time and determine the percentage of waking hours spent sedentary. We explored demographic and stroke-related factors associated with total sedentary time and time in uninterrupted sedentary bouts using unique, both univariable and multivariable, regression analyses. Results: The 274 included participants were from Australia, Canada, and the United Kingdom, and spent, on average, 69% (SD 12.4) of their waking hours sedentary. Of the demographic and stroke-related factors, slower walking speeds were significantly and independently associated with a higher percentage of waking hours spent sedentary (p = 0.001) and uninterrupted sedentary bouts of >30 and >60 min (p = 0.001 and p = 0.004, respectively). Regression models explained 11–19% of the variance in total sedentary time and time in prolonged sedentary bouts. Conclusion: We found that variability in sedentary time of people with stroke was largely unaccounted for by demographic and stroke-related variables. Behavioral and environmental factors are likely to play an important role in sedentary behavior after stroke. Further work is required to develop and test effective interventions to address sedentary behavior after stroke. [ABSTRACT FROM AUTHOR]

Purpose:Charcot Marie Tooth disease (CMT) describes a group of hereditary neuropathies that present with distal weakness, wasting and sensory loss. Small studies indicate that people with CMT have reduced daily activity levels. This raises concerns as physical inactivity increases the risk of a range of co- morbidities, an important consideration in the long-term management of this disease. This study aimed to compare physical activity, patterns of sedentary behavior and overall energy expenditure of people with CMT and healthy matched controls. Methods:We compared 20 people with CMT and 20 matched controls in a comparison of physical activity measurement over seven days, using an activity monitor. Patterns of sedentary behavior were explored through a power law analysis. Results:Results showed a decrease in daily steps taken in the CMT group, but somewhat paradoxically, they demonstrate shorter bouts of sedentary activity and more frequent transitions from sedentary to active behaviors. No differences were seen in energy expenditure or time spent in sedentary, moderate or vigorous activity. Conclusion:The discrepancy between energy expenditure and number of steps could be due to higher energy requirements for walking, but also may be due to an over-estimation of energy expenditure by the activity monitor in the presence of muscle wasting. Alternatively, this finding may indicate that people with CMT engage more in activities or movement not related to walking.Implications for RehabilitationCharcot-Marie-Tooth disease:• People with Charcot-Marie-Tooth disease did not show a difference in energy expenditure over seven days compared to healthy controls, but this may be due to higher energy costs of walking, and/or an over estimation of energy expenditure by the activity monitor in a population where there is muscle wasting. This needs to be considered when interpreting activity monitor data in people with neuromuscular diseases.• Compared to healthy controls, people with Charcot-Marie-Tooth disease had a lower step count over seven days, but exhibited more frequent transitions from sedentary to active behaviors• High Body Mass Index and increased time spent sedentary were related factors that have implications for general health status.• Understanding the profile of physical activity and behavior can allow targeting of rehabilitation interventions to address mobility and fitness. [ABSTRACT FROM PUBLISHER]

The author comments the article "Sedentary Versus Active Behaviour in People After Stroke" by S. L. Galea et al. He discusses the impact of low-physical activity on the morbidity and mortality of healthy individuals. He examines the energy expenditure of stroke survivors in relation to their involvement in activities. He also talks about studies on sedentary behaviour and persons with mild stroke.