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

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 (46 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 (540 steps), medium (41-500 steps), and long (4500 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.