Evaluating the impact of high dose inpatient rehabilitation gait training on post stroke physical activity: A secondary analysis of a randomized controlled trial.

Authors

Paul Mackie, Stanley H Hung, Tara D Klassen, Janice J Eng, DOSE research group

Published in

Archives of physical medicine and rehabilitation. Aug 01, 2026. Epub Aug 01, 2026.

Abstract

This secondary analysis aimed to determine if higher doses of inpatient step training affects physical activity levels 12 months post-stroke. A secondary aim sought to identify whether walking improvements during the subacute rehabilitation stage was predictive of 12-month physical activity.
Multi-site, assessor blinded, randomized controlled trial.
Inpatient rehabilitation.
Stroke patients (<10 weeks post-stroke) admitted to inpatient rehabilitation with lower limb hemiparesis and able to walk 5 meters with or without assistance.
Participants admitted for subacute stroke rehabilitation were randomized to either: Control (usual therapy); DOSE 1, 4 weeks structured and progressive walking and aerobic exercise within usual therapy time (5 hours/week); or DOSE 2, 4 weeks of walking and aerobic exercises within usual therapy time, plus an additional session (2 sessions/day, 10 hours/week).
The treatment effect was examined on physical activity measured by daily steps at 12 months post-stroke. Longitudinal analysis determined predictors of 12-month physical activity based on subacute period change in six-minute walk test from rehabilitation admission (∼1 month post-stroke) to 4-weeks later.
Valid step data were available for 57 participants at 12-months. Participants were on average 54.91 ± 11.45 years, predominantly male (63%), and had impaired mobility (gait speed; 0.41 ± 0.24). There were no group effects on physical activity at 12 months after stroke. Twelve-month physical activity was relatively high (7020 steps/day) across the 3 groups. Longitudinal analysis showed a significant association between change in six-minute walk test during inpatient rehabilitation and combined 12-month physical activity post-stroke (estimated effect: 15.80, 95% Confidence Intervals: 7.06 - 24.54).
Higher walking doses at inpatient rehabilitation did not impact 12-month physical activity. Longitudinal analysis found a positive association with change in distance walked and 12-month physical activity levels, with a gain of 15.8 steps 12 months post-stroke per meter walked.

PMID:
42542201
Bibliographic data and abstract were imported from PubMed on 02 Aug 2026.

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