Physical activity based on daily step-count in inpatient setting in stroke and traumatic brain injury patients in subacute stage: A cross-sectional observational study

Article type: Research Article

Authors: Mischler, Brigitte^{a; b; *} | Hilfiker, Roger^{b; c} | Hund-Georgiadis, Margret^a | Maguire, Clare^{a; b}

Affiliations: [a] Center for Neurorehabilitation and Paraplegiology, REHAB Basel, Basel, Switzerland | [b] Bern University of Applied Science, Department of Health, Bern, Switzerland | [c] Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland

Correspondence: [*] Address for correspondence: Brigitte Mischler, Center for Neurorehabilitation and Paraplegiology, REHAB Basel, Basel, Switzerland. E-mail: [email protected].

Abstract: BACKGROUND:Daily step-count is important post-insult in the subacute phase to influence neuroplasticity, functional recovery and as a predictive factor for activity level one-year post event. OBJECTIVE:Measure daily step-count in subacute patients follow-ing brain injury in an inpatient neurorehabilitation setting and compare these to evi-dence-based recommendations. METHODS:30 participants measured of daily step-count over a seven-day period, throughout the day to assess when and how activity varied. Step-counts were analyzed in sub-groups based on walking ability using the Functional Ambulation Categories (FAC). Correlations between steps-count and FAC level, walking speed, light touch, joint position sense, cognition, and fear of falling were calculated. RESULTS:Median (IQR) daily steps for all patients was 2512 (568.5,4070.5). Not independently walkers took 336 (5–705), the value is below the recommendation. Participants walking with assistance took 700 (31–3080), significantly below recommended value (p = 0.002), independent walkers took 4093 (2327–5868) daily steps, significantly below recommended value (p = < 0.001). Step-count showed moderate to high and statistically-significant correlations: positive for walking speed, joint position sense, negative for fear of falling, and number of medications. CONCLUSIONS:Only 10% of all participants reached the recommended daily steps. Interdisciplinary team-work and strategies to increase daily activity between therapies may be crucial to achieve recommended step-levels in subacute inpatient settings.

Keywords: Neurorehabilitation, stroke, traumatic brain injury, steps, stepcount

DOI: 10.3233/NRE-220248

Journal: NeuroRehabilitation, vol. 52, no. 3, pp. 435-450, 2023