In light of recent PTJ articles on sedentary behavior,1–3 I want to begin a discussion about the potential moderating role of upper extremity (UE) activity on the metabolic effects of sedentary behavior in people with stroke. A great deal of research has demonstrated the cardiovascular and metabolic benefits of physical activity,4 resulting in poststroke physical activity and exercise recommendations5 to counter the low levels of physical activity observed in people with stroke.6,7 In recent years, sedentary behavior, defined as low energy expenditure while sitting or lying down,2 has received increasing attention because sedentary behavior affects lipid and glucose metabolism independent of physical activity.8 Because decreased sedentary behavior is associated with decreased metabolic risk,9 interventions to decrease sitting behavior and increase standing and leisure-based physical activity have been promoted.1,10 For …