Predictors of non-stepping time in people with chronic stroke.
Allison Miller, Kiersten McCartney, Tamara Wright and 1 others
PMID 35993481WHAT IT FOUND
In 280 adults with chronic stroke, lower walking endurance, assistive device use, more depressive symptoms and higher BMI were linked to more non-stepping time.
Programs to break up non-stepping time may need to address these factors, not just cognition or balance confidence.
Key findings
01Data were available for 280 participants, and the mean percentage of time spent in non-stepping behaviors was 81.6%.
02Lower walking endurance, assistive device use, more depressive symptoms and higher BMI were associated with greater non-stepping time.
03The final model explained 28.5% of variability in percent non-stepping time. Physical capacity and psychosocial blocks were significant, while physical health, environment and cognition blocks were not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was cross-sectional, so it cannot show that improving walking endurance, reducing assistive device use, treating depression or lowering BMI will reduce non-stepping time. Non-stepping time was defined as wear-time minutes with 0 steps, so it may include sitting, lying, standing or non-wear time, not only sedentary sitting. The final model explained 28.5% of variability, and 71.5% remained unexplained. Participants had to walk at least 0.3 m/s without assistance, so findings may not apply to people with more severe mobility limitation. Balance self-efficacy was measured only for balance, and other forms of self-efficacy were not assessed.
Declared interests
The authors report no conflict of interest.
The easy way to misread this
Do not conclude that improving walking endurance, removing an assistive device, treating depression or lowering BMI will reduce non-stepping time. This was cross-sectional, so it shows association, not cause, and it did not test behavior change.