Combining Fast-Walking Training and a Step Activity Monitoring Program to Improve Daily Walking Activity After Stroke: A Preliminary Study.
Kelly A Danks, Ryan Pohlig, Darcy S Reisman
PMID 27240430WHAT IT FOUND
Adding step monitoring to fast treadmill training improved daily walking and endurance more than training alone, but only for patients who started with low activity levels.
Those with higher baseline activity did not benefit from the added monitoring.
Key findings
01The combined intervention produced a larger increase in daily steps for patients with low baseline activity compared to fast walking alone.
02Patients with low baseline walking endurance saw greater improvements in 6-minute walk distance with the combined intervention than with fast walking alone.
03Both groups improved in walking speed and daily activity, but the addition of step monitoring did not benefit those with already high baseline activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Small sample size and preliminary nature of the study limit the strength of the conclusions. Participants and therapists were not blinded to group assignment, which could influence behavior or reporting. The study did not compare step monitoring alone to the combined intervention, so it is unclear if the treadmill training was necessary for the added benefit. Adherence to the instruction not to use personal pedometers in the control group was not strictly monitored. The StepWatch monitor used did not provide real-time feedback to patients, which may have limited its effectiveness compared to modern devices.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this combined approach benefits all chronic stroke patients. The added value of step monitoring was only seen in those with low baseline activity or endurance; patients who were already relatively active did not benefit more from the monitoring than from fast walking alone.