Walking activity and its determinants in free-living ambulatory people in a chronic phase after stroke: a cross-sectional study.

BACKGROUND: Free-living walking activity and its contributing factors in ambulatory people with stroke is poorly investigated.

OBJECTIVE: Evaluating free-living walking activity and identifying factors associated with free-living walking activity.

METHODS: In this cross-sectional study, participants wore an accelerometer to measure their level of walking activity. They also completed the Berg Balance Scale (BBS) and the Timed Up and Go test for functional balance, the Falls Efficacy Scale, the 10-Metre Walk Test and the Geriatric Depression Scale to investigate the relation between the performance tests and walking activity.

RESULTS: The 38 analyzed participants were on average 62 (±11.4) years old and 66 (IQR 64.8) months post stroke. They took an average of 3048.3 ± 1983.1 steps, had 123.3 ± 61.3 walking bouts a day and walked for 32.5 ± 18.2 min a day. Their average speed was 90.3 ± 13.8 steps a minute. The multivariate linear analysis showed that the BBS was the only determinant that was significantly related to all outcomes, except walking bouts.

CONCLUSION: Free-living walking activity levels in ambulatory people with chronic stroke are low. The BBS is an independent significant predictor of free-living walking activity. Implications for rehabilitation Free-living walking activity can be expressed in different outcomes measured by accelerometry. Free-living walking activity levels in ambulatory people with chronic stroke are low, therefore support to sustain walking in the own environment should be part of the rehabilitation program after stroke. Balance is an important related factor to free-living walking activity which needs attention during rehabilitation after stroke.