Beyond steps per day: other measures of real-world walking after stroke related to cardiovascular risk.
Allison Miller, Zachary Collier, Darcy S Reisman
PMID 36242083WHAT IT FOUND
Average steps per day did not predict systolic blood pressure in people with stroke.
Instead, walking pace and the number of long sedentary bouts were the key factors. Lab tests of walking capacity missed this relationship, so real-world monitoring is needed to assess cardiovascular risk.
Key findings
01Average bout cadence and long sedentary bouts were the only real-world activity measures significantly associated with systolic blood pressure after accounting for demographics and walking capacity.
02The 6-Minute Walk Test, a common lab measure of walking capacity, was not significantly associated with systolic blood pressure in this model.
03Average steps per day was not found to be related to systolic blood pressure in this sample.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study is cross-sectional, so it cannot prove that changing walking pace or sedentary behavior will directly lower blood pressure. Activity data was collected using a 60-second sampling epoch, which may have underestimated the number of short activity bouts and overestimated active time. The definition of 'non-wear' time involved assumptions that could have misclassified some sedentary time as non-wear or vice versa. Cadence was used as a proxy for intensity, which may be less accurate in people with stroke due to altered gait mechanics and energy expenditure. The model explained only 11.8% of the variance in systolic blood pressure, meaning many other factors influence blood pressure that were not measured here.
Declared interests
The study was funded by the Foundation for Physical Therapy and the National Institutes of Health. No other conflicts of interest were declared.
The easy way to misread this
Do not assume that increasing a patient's total daily steps will lower their blood pressure. In this study, average steps per day was not associated with systolic blood pressure. The significant factors were walking pace and the number of long sedentary bouts.