S. Barak, PhD, Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Pediatric Rehabilitation Department, Sheba Medical Center, Ramat-Gan 52621, Israel, and Physical Education Department, Kaye Academic College of Education, Beer Sheva, Israel.
Phys Ther. 2014 Jan;94(1):101-10. doi: 10.2522/ptj.20120473. Epub 2013 Sep 12.
The step activity monitor (SAM) quantifies steps taken in the home and community by patient populations. Although the SAM has been used to study individuals after stroke, adherence to the use of SAMs has not been addressed. Participants' adherence to wearing the monitor is critical for obtaining accurate assessments.
The purpose of this study was to determine the rate of and predictors for inferred adherence to the use of the SAM after stroke.
A cross-sectional design was used.
Community-dwelling individuals (n=408) 2 months after stroke with moderate-to-severe gait impairment (gait speed of ≤0.8 m/s) were studied. Step activity was assessed for 2 days with the SAM. Inferred adherence was established in 3 periods: 6:00 am to 12:00 pm, 12:01 pm to 6:00 pm, and 6:01 pm to 12:00 am. Adherence was defined as activity recorded in all 3 periods. The percentage of participant adherence for the first day, second day, both days, and either day was calculated. Demographic and clinical characteristics of adherers and nonadherers were compared. Independent adherence predictors were identified by means of stepwise logistic regression.
Inferred adherence rates for the first day, second day, both days, and either day were 68%, 61%, 53%, and 76%, respectively. Upper and lower extremity impairment, balance control, and endurance were significantly different between adherers and nonadherers. On the other hand, older age, greater balance self-efficacy, and better walking endurance were significant predictors of adherence.
Participants were individuals with subacute stroke. Therefore, the findings of this study may not be generalized to individuals during the acute and chronic phases of stroke recovery.
Strategies to improve adherence are needed when collecting data for more than 1 day and in samples with younger individuals and those with low levels of balance self-efficacy and walking endurance.
步活动监测器（SAM）可量化患者在家中和社区中的步数。尽管 SAM 已被用于研究中风后的个体，但尚未解决对 SAM 使用的依从性问题。参与者佩戴监测器的依从性对于获得准确的评估至关重要。
本研究旨在确定中风后使用 SAM 的推断依从率和预测因素。
采用横断面设计。
研究了中风后 2 个月且步态障碍中度至重度（步态速度≤0.8m/s）的 408 名社区居民。使用 SAM 评估 2 天的步活动。在 3 个时间段推断依从性：上午 6:00 至中午 12:00、中午 12:01 至下午 6:00 和下午 6:01 至午夜 12:00。将在所有 3 个时间段记录活动定义为依从。计算了第一天、第二天、两天和任意一天的参与者依从百分比。比较了依从者和不依从者的人口统计学和临床特征。通过逐步逻辑回归确定了独立的依从性预测因素。
第一天、第二天、两天和任意一天的推断依从率分别为 68%、61%、53%和 76%。上肢和下肢损伤、平衡控制和耐力在依从者和不依从者之间有显著差异。另一方面，年龄较大、平衡自我效能感较高和步行耐力较好是依从的显著预测因素。
参与者为亚急性中风患者。因此，本研究的结果可能不适用于急性和慢性中风恢复阶段的个体。
当收集超过 1 天的数据或在年龄较小的个体以及平衡自我效能感和步行耐力较低的样本中收集数据时，需要采取策略来提高依从性。
