Accelerometer and Global Positioning System Measurement of Recovery of Community Ambulation Across the First 6 Months After Stroke: an exploratory prospective study

Objective To characterize community ambulation and determine if it changes across the first 6 months after discharge from hospital after stroke. Design Prospective, observational study. Setting Community setting. Participants Subacute stroke survivors with no cognitive impairment or conditions limiting mobility prior to stroke (N=34). Interventions Not applicable. Main Outcome Measures Community ambulation was measured by an accelerometer, Global Positioning System, and activity diary. Measures included the following: volume (step count; time spent in the community, lying/sitting, standing, and walking), frequency (number of community trips; number of and time in short-, medium-, long-duration bouts), intensity (number of and time at low-, moderate-, high-intensity bouts), and trip type at 1, 3, and 6 months after hospital discharge. Results At 1 month participants took on average 1 trip per day in the community, lasting 137±113 minutes. Overall, most community ambulation was spread across long-duration bouts (>300 steps) lasting 11.3 to 14.1min/d and moderate-intensity bouts (30–80 steps per minute). There was no change in community ambulation trip type (P<.302) or ambulation characteristics over time except for a greater number of and time spent in long ambulation bouts at 6 months only (P<.027). Conclusions Total volume and intensity of community ambulation did not change over the first 6 months postdischarge after stroke. However, at 6 months, survivors spent more time in long-duration ambulation bouts. Review of stroke survivors at 6 months after hospital discharge is suggested because this is when changes in community ambulation may first be observed.