Sedentary behaviour in patients with peripheral arterial disease: Insights from a systematic review, cross-sectional analysis and a mixed method feasibility study

Background: Peripheral arterial disease (PAD) is associated with reduced mobility and elevated cardiovascular risk, yet the role of sedentary behaviour (SB) in this population remains underexplored. Aim: This thesis aimed to assess SB in people with PAD, evaluate measurement approaches, and assess the feasibility and acceptability of an intervention to reduce sedentary time. Methods: A systematic review, two cross-sectional studies, and a 12-week feasibility trial using the activPAL accelerometer were conducted. Findings: The review highlighted high levels of SB across existing studies. Cross-sectional findings confirmed that individuals with PAD spend most waking hours sedentary, often in prolonged, uninterrupted bouts, and that self-reported measures substantially underestimate sitting time while overestimating moderate-to-vigorous physical activity. The intervention demonstrated that targeted behavioural strategies could reduce sitting time, though short-term functional gains were limited by PAD-related pain and barriers such as digital literacy. Device-based measurements provided reliable posture-specific data, highlighting the value of objective tools for future research. Conclusion: Collectively, these findings emphasise the high prevalence and impact of sedentary behaviour in PAD, the importance of accurate measurement, and the potential for behavioural interventions to modify sedentary patterns. Future studies should integrate SB reduction with progressive walking, monitor both behavioural and functional outcomes, and incorporate long-term follow-up to determine sustained benefits for vascular health and overall well-being. Keywords Peripheral arterial disease; sedentary behaviour; sitting; physical activity; activPAL; self-report; feasibility; behavioural intervention

Publisher

University of Galway

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CC BY-NC-ND

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University of Galway Theses (PhD Theses)