Steps after stroke: capturing ambulatory recovery.
OBJECTIVE
Nearly two thirds of stroke survivors have deficits impairing ambulatory recovery. Conventional mobility outcome measures such as timed walks and functional independence measure (FIM) do not quantify free-living ambulatory behavior. This study compared step activity monitoring (SAM) with established instruments to assess ambulatory recovery across the outpatient subacute stroke rehabilitation phase.


METHODS
We measured FIM mobility subscale, SAM-derived daily steps, Stroke Impact Scale (SIS) mobility scores, and timed walks in 11 subjects after discharge from inpatient rehabilitation and again 3 months later.


RESULTS
Significant improvement was measured in free-living step activity (mean gain 80%; P=0.001) but not with timed walks (P=0.4), FIM (P=0.08), or SIS mobility scales (P=0.3).


CONCLUSIONS
Microprocessor-linked SAM is a sensitive indicator of ambulatory recovery that measures improvements not captured by other conventional outcome instruments.
Shaughnessy
Marianne
M
Baltimore VA Geriatrics Research, Education, and Clinical Center, 10 N Greene St, Baltimore, MD 21201, USA. mshaughn@grecc.umaryland.edu
Michael
Kathleen M
KM
Sorkin
John D
JD
Macko
Richard F
RF
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000473:pathology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D009043:Motor Activity; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking