Low gait speed is associated with low physical activity and high sedentary time following stroke

Abstract

Purpose

This study describes physical activity levels and factors associated with physical activity at the end of stroke rehabilitation.

Methods

Primary stroke survivors were assessed at completion of physical rehabilitation. Outcomes included physical activity (e.g. step count, moderate-vigorous physical activity duration) and sedentary time measured with the Sensewear Armband, gait speed, and cognition. The number of participants meeting physical activity recommendations was calculated. Differences in physical activity were examined between household ambulators (gait speed <0.4 m/s), limited community ambulators (0.4–0.8 m/s), and unlimited community ambulators (>0.8 m/s). The influence of age, cognition, and gait speed on physical activity was determined by multiple regression.

Results

Seventy-nine stroke survivors participated. Twenty-one participants achieved 30 min/day of moderate-vigorous physical activity accumulated in 10 min bouts. Unlimited community ambulators took more steps/day (median 4975 vs. 469 limited, 355 household, p < 0.001), had higher moderate-vigorous physical activity (median 74 min/day vs. 22 limited, 31 household, p < 0.001) and lower sedentary time (mean 1105 vs. 1239 limited, 1232 household minutes/day, p < 0.001). Age, gait speed, and cognition predicted 21.3% of the variance in moderate-vigorous physical activity (p = 0.001); adding employment status to the model predicted 57.3% of the variance in step count (p < 0.001).

Conclusions

Physical activity is low following stroke and should be a target for treatment, particularly in those with gait speeds ≤0.8 m/s.

Implications for rehabilitation

• Seventy-three percent of stroke survivors performed ≥30 minutes of moderate to vigorous physical activity throughout the day.

• Twenty-seven percent of stroke survivors accumulated ≥30 minutes of moderate to vigorous physical activity in 10 minute bouts.

• Despite relatively good physical ability, daily step count was low in this sample.

• Those with gait speeds ≤0.8 m/s had lower physical activity levels and higher sedentary time.

Keywords:

• Physical activity
• stroke
• rehabilitation
• gait
• sedentary
• exercise

Acknowledgements

The authors would like to acknowledge the Caulfield Hospital Physiotherapy Department for assistance with patient recruitment.

Disclosure statement

None of the authors have any conflicts of interest to declare in relation to this manuscript.

Additional information

Funding

The primary author is the recipient of a National Heart Foundation of Australia Postgraduate Scholarship (award no.: PP 12M 6983) and an Australian Government Research Training Program Scholarship. This study was supported by a Caulfield Hospital Major Research Grant. The Florey Institute of Neuroscience and Mental Health acknowledges the strong support from the Victorian Government and in particular the funding from the Operational Infrastructure Support Grant.