What factors at discharge predict physical activity and walking outcomes 6 months after stroke? A systematic review.
Neelam Nayak, Niruthikha Mahendran, Suzanne Kuys and 1 others
PMID 39053141WHAT IT FOUND
Physical capability at discharge predicts walking and activity outcomes up to six months after stroke, but explains only part of the result.
Cognitive function and pre-stroke activity levels also contribute significantly. Clinicians should assess these factors to tailor discharge planning and anticipate needs for ongoing care.
Key findings
01Walking distance at discharge predicted daily step count and intensity of physical activity one month later, while age, walking distance, pre-stroke physical activity and executive function predicted physical activity six months later.
02Cognitive function predicted walking independence and participation six months after discharge, even when adjusted for age, lower limb strength and side of stroke.
03Physical capability measures at discharge were the most frequently identified predictive factors, but they only explained a part of the outcome variance, indicating other factors are needed for long-term recovery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only six studies were included, limiting the breadth of evidence. There was substantial heterogeneity in the outcome measures and follow-up time points used across studies, which prevented a meta-analysis and made it difficult to draw firm conclusions. Follow-up periods ranged from one to six months, so findings may not apply to longer-term recovery. The review excluded studies not published in English.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by the University of Queensland's Research Training Program.
The easy way to misread this
Do not assume that improving physical capability at discharge alone will guarantee long-term walking participation or physical activity. The review found that cognitive function and pre-stroke activity levels are also significant predictors, and physical capability measures only explained a part of the outcome variance.