Improvements in Walking During Subacute Stroke Rehabilitation Translate to Physical Activity at the Chronic Stage: A Sub-Analysis From the Phys Stroke Trial.

Stroke frequently results in mobility impairments, contributing to an increased cardiovascular risk. Despite efforts to promote physical activity, stroke survivors fail to meet recommended levels. This secondary analysis of the 'Physical Fitness in Patients with Subacute Stroke' (Phys-Stroke) trial analyzes physical activity at 6 months post-stroke, and examines the effect of gains in walking capacity during the subacute phase on physical activity in the chronic stage. Phys-Stroke compared aerobic exercise vs relaxation in 200 stroke patients. Data from the 6-minute walk test (6MWT) pre and post intervention as well as accelerometry and questionnaire data at 6 months were used. Data was analyzed using mixed linear models and function-on-scalar regression. At 6 months after stroke, participants exhibited low daily step counts (5,623 ± 2,998 steps/day), with most activity occurring in the morning and midday. Per meter gained in the 6MWT during the intervention period, participants increased daily steps by 8.2 (95% confidence interval, 1.6 to 14.8, p = 0.017) at 6 months. Questionnaire data showed that engagement in sports activities was minimal, basic activities being the primary activity. Stroke survivors demonstrated suboptimal activity levels at 6 months but increases in walking capacity during the subacute stage did result in meaningful increases chronically. Trial Registration: ClinicalTrials.gov Identifier: NCT01953549.