A step activity monitoring program improves real world walking activity post stroke

Abstract

Purpose: The purpose of this study was to examine whether the walking activity of persons with stroke could be increased through participation in a step activity monitoring program and to assess whether this occurred through a change in the structure of walking activity. Method: Sixteen individuals living with chronic stroke (>6 months post-stroke) wore a StepWatch Activity Monitor (SAM) and completed a four-week goal centered activity monitoring program. Descriptors of step activity were averaged across baseline and the last week of monitoring, and were used to analyze the changes. Descriptors of step activity included: steps per day, bouts per day, steps per bout, total time walking per day, and the number of short (<40 steps), medium (41–500 steps), and long (>500 steps) walking bouts. Results: As a group, the number of steps per day significantly increased over the four weeks of activity monitoring (p = 0.005). Subjects also demonstrated a significant improvement in the total time walking (p = 0.023), and the number of medium (p = 0.033) and long (p = 0.050) walking bouts. At the baseline and the final assessment, more than half of the bouts were short bouts of walking (67.6 ± 8% and 68.2 ± 8% respectively). Conclusions: A goal centered step activity monitoring program can improve daily walking activity after stroke through increases in the amount of total time walking, and medium and long walking bouts.Implications for RehabilitationParticipation in a goal centered step activity monitoring program may be useful to promote increased activity outside of a clinical setting in individuals post-stroke.Encouraging patients to increase the amount of short, medium, and long bouts of walking, may facilitate an improvement in daily “real world” walking activity.Identifying and developing strategies for patients to overcome perceived barriers, may be critical for success in improving “real world” walking activity.