Evidence map›Paper›PMID 40720450›Full record

Trial reportPloS one2025

Aerobic minutes and step number remain low in inpatient stroke rehabilitation.

Yunyi Yan, Janice J Eng, Stanley H Hung, Mark T Bayley, Krista L Best, Louise A Connell, Sarah J Donkers, Sean P Dukelow, Victor E Ezeugwu, Marie-Hélène Milot and 5 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04238260 (Enhancing Physical Therapy Best Practice for Improving Walking After Stroke), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04238260 nacompletednot on this map

Enhancing Physical Therapy Best Practice for Improving Walking After Stroke

TypeinterventionalSponsorUniversity of British ColumbiaRan2021 to 2025Enrolled306ConditionsStroke, Cerebral Infarction, Brain Ischemia, Infarction, BrainArmsEnhancing Physical Therapy Usual Care, Physical Therapy Usual Care
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Yunyi YanSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
Janice J EngRehabilitation Research Program, G.F. Strong Rehabilitation Centre and Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Stanley H HungRehabilitation Research Program, G.F. Strong Rehabilitation Centre and Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Mark T BayleyDivision of Physical Medicine and Rehabilitation, University of Toronto and KITE Research Institute University Health Network, Toronto, Ontario, Canada.
Krista L BestCentre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Québec City, Quebec, Canada.ORCID https://orcid.org/0000-0001-7205-7725
Louise A ConnellAllied Health Rehabilitation, Lancaster University/East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom.
Sarah J DonkersSchool of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Sean P DukelowDepartment of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Victor E EzeugwuDepartment of Physical Therapy, University of Alberta and Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
Marie-Hélène MilotSchool of Rehabilitation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke and Research Center on Aging, Sherbrooke, Quebec, Canada.
Brodie M SakakibaraDepartment of Occupational Science and Occupational Therapy, Vancouver, BC and Centre for Chronic Disease Prevention and Management, Vancouver, British Columbia, Canada.
Lisa SheehyBruyère Health Research Institute, Ottawa, Canada.
Hubert WongSchool of Population and Public Health, University of British Columbia and Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Jennifer YaoDivision of Physical Medicine and Rehabilitation, University of British Columbia and G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada.
Sue PetersSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.ORCID https://orcid.org/0009-0004-8245-5558

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRehabilitation is important for regaining mobility poststroke. Clinical practice guidelines suggest a high number of repetitive stepping activities to optimize subacute recovery especially when undertaken at intensities that challenge cardiovascular fitness. However, adherence to these guidelines is unclear. The objective of this study was to quantify aerobic minutes and step number in usual care inpatient stroke rehabilitation unit physical therapy sessions across Canada and identify characteristics of participants who met guideline aerobic intensity minutes at a session midpoint in their rehabilitation.

methodsTo gain insight into usual care, we analyzed cross-sectional data from the usual care arm of the Walk 'n Watch implementation trial; trial sites included Canadian rehabilitation units that were not typically involved in research studies. To be included, medically stable patients were admitted for inpatient stroke rehabilitation, and able to take > 5 steps with a maximum of one person assisting. We assessed a midpoint physical therapy session with a wrist-based heart monitor (aerobic minutes) and ankle-based step counter (step number). Means, histograms, and correlations between aerobic minutes (> 40% heart rate reserve) and steps were calculated.

resultsThere were 166 participants (69 females, age 69 standard deviation (SD)12 years) with stroke (138 Ischemic/ 27 Hemorrhagic) included. Participants had a mean of 10(SD11) aerobic minutes and 985(SD579) steps. The relationship between step number and aerobic minutes was negligible (R2 = 0.003). More participants with ≥20 aerobic minutes in a session were male, with lower 6 Minute Walk Test distance, and have a subcortical stroke location.

conclusionThe number of steps has increased, but aerobic minutes has not changed and remains extremely low compared to published reports in the past several years. Given that increasing activity levels are critical for stroke recovery, further investigation into the potential barriers to achieving targets set by guidelines is recommended.

trial registrationClinicalTrials.gov NCT04238260.

Indexed as

ExerciseExercise TherapyStrokeStroke RehabilitationWalkingAgedCanadaCross-Sectional StudiesFemaleHumansInpatientsMaleMiddle Aged

Identifiers

PMID40720450
PMCPMC12303257

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.