Article

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. DESIGN:
A cross-sectional design was used. METHODS: 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. RESULTS:
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. LIMITATIONS:
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. CONCLUSIONS: 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.

Langue : ANGLAIS