Which impairments, activity limitations and personal factors at hospital discharge predict walking activity across the first 6 months poststroke?

Purpose: To determine which impairments, activity limitations and personal factors at hospital discharge poststroke predict volume, frequency, and intensity of walking activity 1, 3, and 6 months later. Materials and Methods: Prospective longitudinal observational study. Thirty-six people with stroke (71 SD 14 years, 69% male) were recruited at hospital discharge and predictors including fatigue, mood, executive function, walking speed, walking endurance, age, prestroke activity, self-efficacy, and perceived stroke recovery and health were collected. At 1, 3, and 6 months follow-up, participants wore an ActivPAL (TM) accelerometer to collect measures of walking activity. Results: At 1 month, walking endurance predicted all walking activity (R-2 > 0.29, p < 0.01). At 3 months, walking endurance and prestroke activity predicted activity volume and intensity (R-2 = 0.46-0.61, p < 0.001), and prestroke activity predicted activity frequency (R-2 = 0.31, p = 0.004). At 6 months, age-predicted activity volume and frequency (R-2 = 0.34-0.35, p < 0.003), while prestroke activity, discharge walking endurance, and executive function together predicted activity intensity (R-2 = 0.79, p < 0.001). Conclusion: Walking endurance contributes to walking activity outcomes across the first 6 months following hospital discharge poststroke. After 1 month of discharge, factors other than poststroke changes also contribute to activity outcomes, and should be considered when targeting poststroke physical activity.