Physical Activity Based on Daily Step-count in Inpatient Setting in Brain Injury Patients: Follow up

Background Brain injury is one of the main causes of permanent physical disability, and improving walking ability is one of the most important goals for patients. After inpatient rehabilitation, most do not receive long-term rehabilitation services. Physical activity is important for the health prevention of the musculoskeletal system, circulatory system and the psyche.

Objective This study measured physical activity on daily step-count in chronic patients after traumatic brain injury and stroke with the StepWatch™ ankle sensor. The difference in number of steps in the inpatient setting were compared to the number of steps 1 year after the event in the outpatient setting.

Methods This follow-up study is a cross-sectional observational study with 29 participants. The number of steps taken in the outpatient setting was compared with the number of steps taken during the inpatient stay and evaluated if they reached the recommended target value. Correlations between steps-count and exit domain, FAC level, walking speed, light touch, joint position sense, cognition, and fear of falling were calculated.

Results The median(IQR) daily step-count of all patients was 2512 (568.5; 4070.5). During follow-up, the number of steps improved to 3185 (1819.9; 5354.1). The average difference was 1159 (–2825; 6840) steps per day. Participants who were unable to walk independently(FAC 1) improved from 336 (5; 705) to 1808 (92; 5354) steps per day. Participants able to walk with assistance(FAC 2-3) walked 700 (31; 3080) and at follow-up 3529 (243; 6871). Independent walkers(FAC 4-5) walked 4093 (2327; 5868) and achieved 3878 (1820; 7418) daily steps at follow-up. This value is significantly below the recommended guideline. Step-count showed moderate to high and statistically significant correlations: positive for FAC Score, FIM total Score, walking speed, and negative for fear of falling.

Conclusions Only 17% of all participants achieved the recommended daily step count one year after the event. We need better inpatient and outpatient strategies to improve physical activity. In everyday clinical practice, pedometers and diaries with objectives should be used. A concrete weekly schedule should be drawn up together with the patient, relatives or nursing staff after discharge. This should include daily self-training, which was instructed during the inpatient stay.

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Artikel online veröffentlicht:
23. Oktober 2025