Mobility Activity of Stroke Patients During Inpatient Rehabilitation

The purposes of this study were to quantify the actual upright activity of inpatient stroke patients in order to investigate the influence of disability, physiotherapy contact time, and time since stroke on the amount of activity recorded. Forty-one inpatients from three Glasgow stroke units were monitored during one therapeutic day. Measurements were made using an instrumented recording device which quantified (i) the proportion of time spent upright, and (ii) the frequency of transitions to upright. The results were compared to a global measure of disability, the Barthel Index, a functional mobility scale, the Rivermead Mobility Index (RMI) and walking speed. Results were also compared to time spent in physiotherapy and the time since their stroke. The patients spent an average of 8.3% of the therapeutic day upright. They transitioned to upright an average of 2.6 times/hour. There were significant correlations between upright activity (proportion of time) and Barthel Index score (r = 0.79, p < 0.01), RMI score (r = 0.77, p < 0.01), walking speed (r = 0.48, p = 0.02), and physiotherapy time (r = 0.43, p = 0.01). Physiotherapy contact time was independently related to activity, indicating that physiotherapy directly influences quantity of mobility activity during inpatient rehabilitation. The patients spent a small proportion of the therapeutic day upright despite being in dedicated stroke rehabilitation units, and each patient's activity level was dependent upon both their level of disability and the amount of physiotherapy input they received.