Protocol for promoting recovery optimization of walking activity in stroke (PROWALKS): a randomized controlled trial.
Study Goal
The researchers aimed to determine whether combining fast walking training with a step activity monitoring program improves real-world walking activity more effectively than either intervention alone in chronic stroke survivors.
Results Summary
The study assessed improvements in steps per day, walking speed, endurance, and other outcomes, with follow-ups at 6 and 12 months, but specific results were not detailed in the abstract. The interventions were evaluated for efficacy and individual responsiveness.
Population
Chronic stroke survivors (>6 months post-stroke) with baseline walking speed between 0.3 m/s and 1.0 m/s and average steps/day <8000.
Effective Dosage
Not specified
Duration
12 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
fast walking training | increase | walking capacity | stroke survivors | - | improves | #1 |
step activity monitoring program | increase | real-world walking activity | stroke survivors | - | facilitates translation of gains from the clinic to the "real-world" | #2 |
fast walking training + step activity monitoring program | increase | real world walking activity | stroke survivors | - | would generate greater improvements | #3 |
BACKGROUND: Stroke survivors are more physically inactive than even the most sedentary older adults, and low activity is associated with increased risk of recurrent stroke, medical complications, and mortality. We hypothesize that the combination of a fast walking intervention that improves walking capacity, with a step activity monitoring program that facilitates translation of gains from the clinic to the "real-world", would generate greater improvements in real world walking activity than with either intervention alone. METHODS: Using a single-blind randomized controlled experimental design, 225 chronic (> 6 months) stroke survivors complete 12 weeks of fast walking training, a step activity monitoring program or a fast walking training + step activity monitoring program. Main eligibility criteria include: chronic ischemic or hemorrhagic stroke (> 6 months post), no evidence of cerebellar stroke, baseline walking speed between 0.3 m/s and 1.0 m/s, and baseline average steps / day < 8000. The primary (steps per day), secondary (self-selected and fastest walking speed, walking endurance, oxygen consumption) and exploratory (vascular events, blood lipids, glucose, blood pressure) outcomes are assessed prior to initiating treatment, after the last treatment and at a 6 and 12-month follow-up. Moderation of the changes in outcomes by baseline characteristics are evaluated to determine for whom the interventions are effective. DISCUSSION: Following completion of this study, we will not only understand the efficacy of the interventions and the individuals for which they are effective, we will have the necessary information to design a study investigating the secondary prevention benefits of improved physical activity post-stroke. This study is, therefore, an important step in the development of both rehabilitative and secondary prevention guidelines for persons with stroke. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02835313 . First Posted: July 18, 2016.