Study identifies distinct sedentary behavior patterns in patients with stroke undergoing inpatient rehabilitation

Researchers at Kanazawa University and the Japanese Stroke & Physical activity mUltiple center Research Team (J-SPURT) have identified distinct sedentary behavior patterns among patients with stroke undergoing inpatient rehabilitation.

Sedentary behavior refers to time spent sitting, reclining, or lying down while awake. It is highly prevalent during stroke rehabilitation. Although reducing sedentary time and promoting physical activity are important goals, patients with stroke may differ not only in how much time they spend sedentary, but also in how that sedentary time is accumulated and interrupted.

In this multicenter prospective study, the research team analyzed data from 420 patients with stroke admitted to 14 rehabilitation hospitals in Japan. Sedentary behavior was objectively assessed using triaxial accelerometers at admission and again 1 month later. The researchers applied cluster analysis using five sedentary behavior indicators: short (<30 minutes), medium (30–59 minutes), and long (≥60 minutes) sedentary bout ratios; total sedentary time; and break frequency.

The analysis identified three subgroups: a low sedentary behavior group, a moderate sedentary behavior group, and a high sedentary behavior group. The study also found that changes in sedentary behavior patterns from admission to 1 month differed among these groups.

These findings suggest that support for reducing sedentary behavior after stroke should not take a one-size-fits-all approach. Early behavioral profiling using sedentary behavior indicators may help guide the development of individualized strategies to reduce sedentary time during rehabilitation.

“We hope that this study will serve as a starting point for considering more individualized support for patients after stroke,” said Dr. Masashi Kanai of Kanazawa University. “Rather than simply trying to reduce sedentary time in the same way for all patients, it may be important to understand each patient’s sedentary behavior pattern and how it changes during rehabilitation. We will continue working to promote the assessment of physical activity and sedentary behavior in clinical practice.”

The study was published online in the Journal of Neurologic Physical Therapy on April 21, 2026.

This work was supported by JSPS KAKENHI, Grant-in-Aid for Early-Career Scientists (Grant Number: JP22K17665).