The Impact of Sedentary Behavior on Stroke Prognosis: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Background: Stroke survivors often experience physical dysfunction, fatigue, and cognitive impairment, and may also spend prolonged periods engaged in sedentary behavior because of daily living demands. However, the specific effects of sedentary behavior on stroke prognosis remain unclear. Methods: A comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science, covering all records from database inception to March 2026, was conducted through both computer-based and manual methods. Results: A random-effects model was applied for the meta-analysis. Seven studies involving 1874 participants, with a median follow-up duration of 2.17 years, were included. During the post-stroke period characterized by sedentary behavior, changes in the fatigue severity scale (FSS; 95% CI: 2.99-3.42, P = 0.02) and physical function (SIS, BMI, and BAPAS) were observed in 202 participants. In addition, the incidence of various diseases during follow-up was increased in 1374 participants, and changes in blood glucose levels were reported in 178 participants. However, owing to the heterogeneity of assessment scales used across studies, the forest plots showed substantial heterogeneity (I² > 80%). Therefore, our findings have limited clinical interpretability and should be considered to indicate overall trends. Conclusions: The overall trends from this meta-analysis suggest that higher sedentary behavior may be associated with adverse effects on physical function, fatigue, cardiovascular events, and blood glucose levels during stroke prognosis. Such behavior might decrease quality of life during survival, and increase the risks of stroke recurrence and other diseases. The specific mechanisms underlying the association between sedentary behavior and stroke prognosis require further investigation and confirmation.

Keywords

Sedentary behavior / Stroke / Meta-analysis / Prognosis

References

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