Characterizing energy expenditure during sedentary behavior after stroke

OBJECTIVE: To objectively measure and calculate the energy expended by people with stroke during near sedentary behaviors (lying, supported and unsupported sitting, standing, wheelchair propulsion and walking), under controlled laboratory conditions, and compare these values to the energy expenditure of 1.5 Metabolic Equivalent of Task (METs) within the definition of sedentary behavior.

DESIGN: Cross-sectional cohort study.

SETTING: Rehabilitation Institutions PARTICIPANTS: Twenty-seven people with stroke (mean age 61.0 ± 11.7 years), categorized at Functional Ambulation Category 0 to 5.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE(S): 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 as well as categorized by the Functional Ambulation Categories (FAC).

RESULTS: For the total group the mean METs +/- standard deviation 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 categories METs values above 1.5 when propelling a wheelchair or walking.

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