Distance-Induced Changes in Walking Speed After Stroke: Relationship to Community Walking Activity.
Louis Awad, Darcy Reisman, Stuart Binder-Macleod
PMID 31449180WHAT IT FOUND
After stroke, people who slowed more during the 6-minute walk walked far fewer daily steps than those with similar total distance but steadier speed.
Check speed decline, not just distance, when judging walking activity.
Key findings
01A larger decline in walking speed from minute 1 to minute 6 of the 6-minute walk was independently linked to fewer daily steps after stroke.
02The link between total 6-minute walk distance and daily steps depended on how much speed declined during the test.
03A balance-confidence score was associated with daily steps but was not a significant independent predictor in the final analysis.
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
This was an exploratory study, not a treatment trial, so it shows associations rather than causes. Only people who could walk for six minutes without physical assistance were included, so it does not apply to more impaired patients who cannot complete the test. The study was limited to higher functioning, community-dwelling people after stroke. The sample was 40 people, and three outlier data points were removed from the final analysis. The 6-minute walk was performed with instructions to cover as much distance as possible, and results may differ if that instruction is not used. The authors note that balance confidence may overlap with walking capacity rather than being unimportant, even though it was not an independent predictor in this model.
The easy way to misread this
Do not conclude that improving walking speed during the 6-minute walk will increase daily steps. This study did not test any treatment, so it cannot show that changing speed will change daily steps.