Day-to-Day Variability of Walking Performance Measures in Individuals Poststroke and Individuals With Parkinson Disease.
Carey L Holleran, Marghuretta D Bland, Darcy S Reisman and 3 others
PMID 32769671WHAT IT FOUND
People who walk more each day have larger swings in their step counts from one day to the next.
For someone averaging 5,000 steps, daily variation can exceed 2,300 steps. Clinicians need multiple days of data to distinguish real improvement from normal fluctuation.
Key findings
01Individuals with higher average daily walking exhibited greater day-to-day variability in their step counts.
02For participants averaging around 5,000 steps per day, the range of day-to-day variability extended from about 750 to over 2,300 steps.
03Living in areas with higher socioeconomic disadvantage predicted increased day-to-day variability in steps per day, even after accounting for the average amount of walking.
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 used 1-minute epochs to calculate walking duration and other metrics, which likely overestimated the actual time spent walking because any minute with a step count was counted as a minute of walking. Gait speed was used as the measure of walking capacity. While convenient, it explains only a portion of the variance in daily walking performance, and other measures like the six-minute walk test might have shown stronger relationships. Some of the observed relationship between amount and variability may be mathematical rather than purely behavioral, as higher averages allow for a wider possible range of variability. The analysis excluded participants who could not walk without physical assistance or who had gait speeds of 1.2 m/s or higher, limiting generalizability to those extremes.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not assume that a patient's walking capacity in the clinic accurately predicts their daily step count variability. Walking speed and daily activity are only moderately related, and a patient's average daily step count is a better predictor of their day-to-day fluctuation than their clinical gait speed.