Protocol for promoting recovery optimization of walking activity in stroke (PROWALKS): a randomized controlled trial

Area of Science:

• Neurology
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Stroke survivors exhibit significantly lower physical activity levels compared to sedentary older adults.
• Low physical activity in stroke survivors increases risks of recurrent stroke, complications, and mortality.
• Current interventions need to bridge the gap between clinic-based improvements and real-world activity.

Purpose of the Study:

• To investigate the combined efficacy of fast walking training and step activity monitoring on real-world walking activity in stroke survivors.
• To determine if combined interventions yield greater improvements than individual interventions.
• To identify subgroups of stroke survivors who benefit most from these interventions.

Main Methods:

• A single-blind randomized controlled trial involving 225 chronic stroke survivors.
• Interventions included 12 weeks of fast walking training, step activity monitoring, or a combination.
• Outcomes assessed included daily steps, walking speed, endurance, and secondary prevention markers, with 6 and 12-month follow-ups.

Main Results:

• The study will provide data on the efficacy of each intervention and their combination.
• Analysis will identify which stroke survivor characteristics predict positive responses to the interventions.
• Results will inform the design of future studies on secondary stroke prevention.

Conclusions:

• This study is crucial for developing effective rehabilitative and secondary prevention strategies for stroke survivors.
• Findings will guide the creation of evidence-based guidelines for physical activity post-stroke.
• Understanding intervention efficacy is key to improving long-term health outcomes for this population.