Readiness to Change is Related to Real-World Walking and Depressive Symptoms in Chronic Stroke.

This was a cross-sectional baseline analysis, so it cannot show that readiness to change causes more walking or fewer depressive symptoms. The sample was not balanced across stages: only 2 people were in Precontemplation and 6 in Action, so those stages were removed from the main analysis. Participants were recruited for a clinical trial about increasing walking activity, so they may have been more motivated to change than people with stroke who are not active at all. Every participant had to walk at 0.3 m/s or faster, so the results do not cover people with very slow walking. The readiness statement and the Fitbit step count did not always match: some people who said they were active sometimes did not reach 8,000 steps per day, and some who said they were in Maintenance did not meet that definition. Fatigue and the energy cost of walking were not measured, so they could have influenced the step counts or readiness responses. The relapse question did not define a time frame, so it is not clear when participants stopped being regularly active. The balance self-efficacy measure was not specific to walking activity, and no walking activity self-efficacy measure was used. This was the first study to examine readiness to change and stepping activity in stroke, so the authors call the findings preliminary.

No conflict-of-interest or funding statement is included in the supplied text. The publication types list NIH extramural research support and non-U.S. government research support.

Do not conclude that increasing readiness to change will raise daily steps or reduce depressive symptoms. This was a cross-sectional association in people selected for a walking trial, and it cannot show whether readiness changed behavior, or behavior and mood changed readiness.