Article

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
DeltaR(2) 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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS