Abstract
Objectives
To determine preliminary efficacy and to identify baseline characteristics predicting
who would benefit most from fast walking training plus a step activity monitoring
program (FAST+SAM) compared with fast walking training (FAST) alone in persons with
chronic stroke.
Design
Randomized controlled trial with blinded assessors.
Setting
Outpatient clinical research laboratory.
Participants
Individuals (N=37) >6 months poststroke.
Interventions
Subjects were assigned to either FAST, which was walking training at their fastest
possible speed on the treadmill (30min) and overground 3 times per week for 12 weeks,
or FAST+SAM. The step activity monitoring program consisted of daily step monitoring
with an activity monitor, goal setting, and identification of barriers to activity
and strategies to overcome barriers.
Main Outcome Measures
Daily step activity metrics (steps/day [SPD], time walking per day), walking speed,
and 6-minute walk test (6MWT) distance.
Results
There was a significant effect of time for both groups, with all outcomes improving
from pre- to posttraining (all P values <.05). The FAST+SAM was superior to FAST for 6MWT (P=.018), with a larger increase in the FAST+SAM group. The interventions had differential
effectiveness based on baseline step activity. Sequential moderated regression models
demonstrated that for subjects with baseline levels of step activity and 6MWT distances
that were below the mean, the FAST+SAM intervention was more effective than FAST (1715±1584
vs 254±933 SPD; P<.05 for overall model and ΔR2 for SPD and 6MWT).
Conclusions
The addition of a step activity monitoring program to a fast walking training intervention
may be most effective in persons with chronic stroke who have initial low levels of
walking endurance and activity. Regardless of baseline performance, the FAST+SAM intervention
was more effective for improving walking endurance.
Keywords
List of abbreviations:
FAST (fast walking training), FAST+SAM (fast walking training plus a step activity monitoring program), 6MWT (6-minute walk test), SPD (steps per day), THR (target heart rate)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 27, 2016
Footnotes
Supported by the National Institutes of Health (grant no. R21HD07142).
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
