Feasibility and Outcomes of a Community-Based, Pedometer-Monitored Walking Program in Chronic Stroke: A Pilot Study

Abstract

Background and Purpose: After stroke, many individuals have reduced physical activity. Pedometer use is reported to enhance physical activity in patients with other health conditions. The purpose of this study was to investigate the feasibility of a community-based, pedometer-monitored walking program and determine its effects on gait speed and distance, quality of life, and balance self-efficacy post stroke. Methods: A single-group, pretest-posttest follow-up design was used. Eleven individuals with chronic stroke (mean age, 60.4 years; mean time since stroke, 12.2 years) completed a pedometer-monitored, community-based intervention. Primary outcomes were the 6-minute walk test (6MWT) and 10-meter walk test. Secondary outcomes were the Activities-Specific Balance Confidence Scale, Stroke Impact Scale-16 (SIS-16), and a pedometer satisfaction survey. Subjects used pedometers daily for 6 weeks and recorded step counts, adverse symptoms, and exertion levels in exercise diaries. Weekly phone coaching was used to set walking goals. Results: No adverse events occurred. All subjects were able to don pedometers, 91% could read step counts, and 80% expressed satisfaction. There were no significant group changes across outcome measures. There were moderate effect sizes for changes in SIS-16 (0.312) and 6MWT (0.293). Increasing steps correlated with increased perception of physical function. Discussion: The results support the feasibility of and participant satisfaction with a community-based, pedometer-monitored walking program post stroke. Limitations include small sample size and lack of a comparison group. Conclusions: This study represents a preliminary step in determining the effectiveness of pedometer-based interventions for enhancing physical activity in persons with chronic stroke. Further study is warranted.