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

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.