Abstract
Background: High-intensity treadmill training and self-management strategies positively effect walking outcomes after stroke. However, it is unclear how these strategies can be matched to individuals after stroke.
Aims: This study aimed to evaluate novel clusters of stroke survivors based on baseline and intervention characteristics, predicting improvement in walking speed six months after an intervention post-stroke.
Methods: This study is a secondary analysis of data from a randomized controlled trial of adults within two months of stroke. Fifty-six participants received a self-management program embedded in high-intensity treadmill gait training (3 x 30-minute sessions per week, 8 weeks). Baseline characteristics included demographic details, daily step count, walking and exercise self-efficacy. Intervention characteristics included treadmill performance (speed, distance, and rate of perceived exertion) and self-management strategies used. Primary outcomes consisted of comfortable and fast walking speed, measured at baseline and six months after intervention. A machine learning-based unsupervised clustering approach was used to identify clusters. Multiple regression models were used to identify predictors.
Results: Three distinct clusters were identified: Cluster 1 [n=20, mean age = 58 (11)], Cluster 2 [n=15, mean age = 70(9)] and Cluster 3 [(n=21, mean age = 61(11)]. Clusters had baseline mean comfortable walking speed of 1.2 (0.07) m/s, 0.9 (0.11) m/s and 0.64 (0.14) m/s respectively. Walking related self-efficacy and treadmill training speed predicted comfortable walking speed (adjusted r2 = 0.67, p<0.001). Self-management strategies and treadmill training distance predicted fast walking speed (adjusted r2 = 0.82, p<0.001).
Conclusion: This study highlights that adults with stroke may need different strategies to improve walking speed. Baseline characteristics such as walking speed, walking self-efficacy, fatigue and stroke severity, as well as intervention strategies including treadmill training speed, intensity and self-management could be used to target long-term walking speed changes in people with stroke.
Aims: This study aimed to evaluate novel clusters of stroke survivors based on baseline and intervention characteristics, predicting improvement in walking speed six months after an intervention post-stroke.
Methods: This study is a secondary analysis of data from a randomized controlled trial of adults within two months of stroke. Fifty-six participants received a self-management program embedded in high-intensity treadmill gait training (3 x 30-minute sessions per week, 8 weeks). Baseline characteristics included demographic details, daily step count, walking and exercise self-efficacy. Intervention characteristics included treadmill performance (speed, distance, and rate of perceived exertion) and self-management strategies used. Primary outcomes consisted of comfortable and fast walking speed, measured at baseline and six months after intervention. A machine learning-based unsupervised clustering approach was used to identify clusters. Multiple regression models were used to identify predictors.
Results: Three distinct clusters were identified: Cluster 1 [n=20, mean age = 58 (11)], Cluster 2 [n=15, mean age = 70(9)] and Cluster 3 [(n=21, mean age = 61(11)]. Clusters had baseline mean comfortable walking speed of 1.2 (0.07) m/s, 0.9 (0.11) m/s and 0.64 (0.14) m/s respectively. Walking related self-efficacy and treadmill training speed predicted comfortable walking speed (adjusted r2 = 0.67, p<0.001). Self-management strategies and treadmill training distance predicted fast walking speed (adjusted r2 = 0.82, p<0.001).
Conclusion: This study highlights that adults with stroke may need different strategies to improve walking speed. Baseline characteristics such as walking speed, walking self-efficacy, fatigue and stroke severity, as well as intervention strategies including treadmill training speed, intensity and self-management could be used to target long-term walking speed changes in people with stroke.
Original language | English |
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Pages | 72 |
Number of pages | 1 |
DOIs | |
Publication status | Published - 2023 |
Event | Stroke 2023 - The Joint Annual Scientific Meeting of the Stroke Society of Australasia & Smart Strokes - Centrepiece, Melbourne, Australia Duration: 22 Aug 2023 → 25 Aug 2023 https://www.stroke2023.org/ https://stroke-2023.p.asnevents.com.au/ (Program) https://journals.sagepub.com/toc/wsoa/18/2_suppl (Published abstracts) |
Conference
Conference | Stroke 2023 - The Joint Annual Scientific Meeting of the Stroke Society of Australasia & Smart Strokes |
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Abbreviated title | Championing Care |
Country/Territory | Australia |
City | Melbourne |
Period | 22/08/23 → 25/08/23 |
Other | A welcome from The Stroke Society of Australasia and Smart Strokes Scientific Meeting Organising Committee We would like to extend a warm invitation to join us in Melbourne in August 2023, for the combined Stroke Society of Australasia and Smart Strokes Nursing and Allied Health Scientific Meeting. Building on the previous success of our interprofessional combined meetings, the theme for the 2023 conference is “Championing Care”. Our vibrant program aims to provide insights into the latest research for high quality treatments and therapies across the continuum of care. We will be highlighting our co-designed research, patient advocacy initiatives and expanding on cutting edge research methods, to transform clinical practice and improve patient outcomes. This year’s meeting will take place within the sporting precinct of Melbourne, a diverse city with beautiful public green spaces, a vibrant arts and cultural scene, internationally renowned dining and a rich indigenous heritage. The city has seen many international successes across the whole spectrum of the sporting arena. We hope to similarly inspire attendees to be “champions of care” for stroke, nationally and internationally. In striving towards the goals of improved evidence-based care, therapies and outcomes for stroke we will build on the accomplishments of previous meetings and the translation of new emerging research that informs our field. This conference will showcase our region’s exemplary research, clinical leadership and the growing capacity of all members of the SSA and Smart Strokes community from Australia, New Zealand, and internationally through our workshops, discussion forums, presentations and plenary sessions. Please do join us in August 2023 in Melbourne. |
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