Breaking up sitting time after stroke (BUST-Stroke)

It will never happen. Our doctors don't read and implement information from stroke research. And we have NO stroke leadership pushing such information out to stroke hospitals. Incompetency run amok in the stroke world. But what the hell, it is just stroke survivors that are impacted. And since 90% of strokes are preventable, the problem is completely on the patient to solve. You caused it, you solve it.
http://wso.sagepub.com/content/early/2016/10/27/1747493016676616.abstract

1. Heidi Janssen1,2,3,4⇑
2. David W Dunstan5
3. Julie Bernhardt6,7
4. Frederick R Walker2,4,8
5. Amanda Patterson3
6. Robin Callister2,4,8,9
7. Ashlee Dunn9
8. Neil J Spratt2,4,8,10
9. Coralie English2,3,4

1. ¹Hunter Stroke Service, Hunter New England Local Health District, Newcastle NSW, Australia
2. ²Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle NSW, Australia
3. ³School of Health Sciences, Faculty of Health, University of Newcastle, Newcastle NSW, Australia
4. ⁴Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle NSW, Australia
5. ⁵Baker IDI Heart and Diabetes Institute, Melbourne VIC, Australia
6. ⁶Centre for Research Excellence in Stroke Rehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg VIC, Australia
7. ⁷University of Melbourne, Parkville VIC, Australia
8. ⁸School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle NSW, Australia
9. ⁹Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle NSW, Australia
10. ¹⁰Department of Neurology, John Hunter Hospital, Hunter New England Local Health District, Newcastle NSW, Australia

1. Heidi Janssen, Hunter Medical Research Institute, Stroke Recovery Group, Level 3 East, Kookaburra Crt, New Lambton Heights, NSW 2305, Australia. Email: heidi.janssen@hnehealth.nsw.gov.au

Abstract

Rationale Prolonged sitting is associated with an increased risk of cardiovascular and all-cause mortality and morbidity. The metabolic and cardiovascular effects of breaking up sitting time in people with stroke are unknown.

Aims and hypotheses To determine the (i) metabolic and cardiovascular effects and (ii) safety and feasibility of an experimental protocol to break up uninterrupted sitting in people with stroke. We hypothesize that activity breaks will attenuate the effects of uninterrupted sitting on glucose and insulin metabolism, blood pressure, lipid profiles, and plasma fibrinogen and that it will be both safe and feasible.

Sample size estimate Based on previous estimates of population variability (SD 1% glucose and 30% insulin), 19 paired observations (i.e. participants) will achieve a power of 0.9 to detect a difference of 0.8% in glucose and 24% in insulin area under the curve (two-tailed testing, α = 0.05).

Methods and design People with stroke will complete three experimental conditions one week apart in randomized order: (a) uninterrupted sitting, (b) prolonged sitting with intermittent walking, and (c) prolonged sitting with intermittent standing exercises. Serial blood samples will be collected and blood pressure measured at 30 min intervals for 8 h.

Study outcomes Primary outcome will be postprandial glucose and insulin responses. Secondary outcomes will include fibrinogen concentrations, blood pressure, and adverse events and protocol feasibility.

Discussion This is the first important step in determining the cardiovascular effects of breaking up sitting time after stroke. Findings will guide future studies testing behavioral strategies to reduce sitting time for the purpose of lowering recurrent stroke risk.