Secondary Analysis of Walking Activities during the Acute Stroke Hospital Stay and Cerebrovascular Health.
Alicen A Whitaker, Madison L Henry, Allegra Morton and 4 others
PMID 35910593WHAT IT FOUND
Stroke survivors who walked farther during their acute hospital stay showed a better brain blood flow response to exercise three months later.
Resting blood flow and walking frequency did not differ between groups. This observational link does not prove that walking more caused the improvement.
Key findings
01Participants who walked farther in the hospital had a greater cerebrovascular response to moderate-intensity exercise at 3 months post-stroke in both the injured and non-injured sides of the brain.
02There was no significant difference in resting middle cerebral artery blood velocity between the groups, though the effect sizes were large.
03Walking frequency during the acute stay was low and similar between groups, averaging about 2 times per day, which is far below the 10 times per day recommended by the AVERT trial.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and observational, so it cannot prove that walking more in the hospital caused the better brain blood flow response at 3 months. The sample size was very small (20 participants), and confounding factors like age, sex, and medications were not statistically controlled. Walking intensity during the acute hospital stay was unknown because heart rate was not recorded at that time. The participants were all able to walk more than 10 meters without assistance, so the findings do not apply to non-ambulatory stroke survivors. The study was underpowered to detect differences in resting brain blood flow.
Declared interests
The authors declared no conflicts of interest. The study was funded by the American Heart Association and the University of Kansas Medical Center.
The easy way to misread this
Do not interpret the better brain blood flow response in the high-walking group as proof that increasing walking distance during the acute stay will improve cerebrovascular health. This was an observational secondary analysis with a small sample size, and the study did not control for confounding factors like age, medications, or rehabilitation intensity.