Predictors of Daily Steps at 1-Year Poststroke: A Secondary Analysis of a Randomized Controlled Trial.
Predictors of Daily Steps at 1-Year Poststroke: A Secondary Analysis of a Randomized Controlled Trial.
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DOI：
10.1161/strokeaha.121.034249
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发表时间：
2021-05
期刊：
影响因子：
8.3
通讯作者：
Fritz SL
中科院分区：
文献类型：
--
作者：
Handlery R;Regan EW;Stewart JC;Pellegrini C;Monroe C;Hainline G;Handlery K;Fritz SL
步行有可能提高中风后的耐力和社区参与度。每天获得≥6,000步可以降低随后的中风风险。及早发现那些容易每天步行较少的人可以促进干预，从而增加步行和改善健康。本研究的目的是1)确定卒中后两个月哪些因素可以预测一年的每日步数，以及2)确定卒中后两个月的步数与卒中后一年获得≥6000每日步数的对应关系。这是对中风后运动体验应用试验数据的二次分析，该试验招募了中风后两个月步行速度为0.80米/S的参与者。在卒中后两个月和一年评估每日步数。根据年龄、性别、种族和/或民族、中风严重程度、步行速度、耐力、健康、运动功能、平衡和平衡信心等因素，使用线性回归预测一年中的每日步数。受试者工作特征(ROC)曲线确定了哪一步数对应于一年达到≥6000步。分析了206名参与者的数据，平均年龄=63(13)岁，其中43%为女性，平均每日基线步数=2922(2749)步。预测卒中后一年每日步数的最终模型包括两个月的每日步数和平衡值(伯格平衡量表评分)；这些因素解释了一年内每日步数变异性的38%(p=0.001)。在两个月时达到≥1632d步数的参与者在卒中后一年达到≥6000d步数的可能性是1.86倍(95%可信区间为1.52to2.27)。卒中后两个月的每日步数和平衡度是预测未来每日步数的最有力指标。改善日常体力活动和卒中后早期的目标平衡对于增加卒中后一年的体力活动可能是必要的。
Walking has the potential to improve endurance and community participation after stroke. Obtaining ≥6000 daily steps can decrease subsequent stroke risk. Early identification of those prone to low daily steps could facilitate interventions that lead to increased walking and improved health. The purpose of this study was to 1) determine which factors at two months post-stroke can predict daily step counts at one year, and 2) determine what step count at two months corresponds to obtaining ≥6000 daily steps at one year post-stroke. This was a secondary analysis of data from the Locomotor Experience Applied Post Stroke trial, which enrolled participants with walking speeds <0.80 m/s at two months post-stroke. Daily steps were assessed at two months and one year post-stroke. Linear regression was used to predict daily step counts at one year based on factors including age, gender, race and/or ethnicity, stroke severity, walking speed, endurance, fitness, motor function, balance and balance confidence. A Receiver Operating Characteristic (ROC) curve determined which step count corresponded to reaching ≥6000 steps at one year. Data from 206 participants, mean age=63 (13) years, 43% female, mean baseline daily step count=2922 (2749) steps, were analyzed. The final model to predict daily steps at one year post-stroke contained daily steps at two months and balance (Berg Balance Scale score); these factors explained 38% of the variability in daily steps at one year (p=<0.001). Participants obtaining ≥1632 daily steps at two months were 1.86 (95% CI 1.52 to 2.27) times more likely to reach ≥6000 daily steps at one year post-stroke. Daily steps and balance at two months post-stroke were the strongest predictors of future daily steps. Improving daily physical activity and targeting balance early after stroke may be necessary to increase physical activity at one year post-stroke.