Cognitive Function is a Predictor of the Daily Step Count in Patients With Subacute Stroke With Independent Walking Ability: A Prospective Cohort Study.
Daisuke Ito, Michiyuki Kawakami, Yuya Narita and 3 others
PMID 34589683WHAT IT FOUND
Among subacute stroke patients who could walk independently, lower cognitive scores on admission predicted fewer daily steps at discharge.
Physical measures like walking speed and motor function were not significant predictors in the final model.
Key findings
01In multiple regression analysis, the only significant predictor of daily step count at discharge was the MMSE score at admission.
02Patients with mild cognitive impairment (MMSE 24-27) walked significantly fewer steps than those with normal cognitive function (MMSE 28-30).
03Physical factors such as walking speed, motor function, and functional independence were not significant predictors of daily step count after adjustment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted at a single facility, which limits generalizability. Patients with severe cognitive impairment (MMSE ≤ 23) and aphasia were excluded, so the findings do not apply to this group. The pedometer measured only step count, not the intensity or duration of activity. The study was observational and cannot prove that cognitive impairment causes lower activity levels.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Ethics Committee of Tokyo Bay Rehabilitation Hospital.
The easy way to misread this
Do not assume that physical therapy interventions alone will increase step counts in patients with mild cognitive impairment. The study found that cognitive scores, not physical function, were the significant predictor of activity levels, suggesting that cognitive support may be necessary to improve ambulatory activity.