{"doi":"10.1093/ptj/pzaf070","title":"Matching Clinical Profiles With Interventions to Optimize Daily Stepping in People With Stroke","abstract":"IMPORTANCE: Individualizing interventions is imperative to optimize step-activity in people with chronic stroke. OBJECTIVE: The objective was to group individuals with chronic stroke into clinical profiles based on baseline characteristics and examine if these profiles preferentially benefitted from a specific intervention to improve daily step-activity. DESIGN: This is a secondary analysis of a randomized control trial. SETTING: The parent study occurred at 4 outpatient rehabilitation clinics. PARTICIPANTS: Participants had strokes ≥6 months prior to enrollment, were 21 to 85 years old, had walking speeds of 0.3 to 1.0 meters per second, and took <8000 steps-per-day. INTERVENTIONS: Participants were randomized to high-intensity treadmill training (FAST), a step-activity behavioral intervention (SAM), or a combined intervention (FAST+SAM). MAIN OUTCOME(S): The primary outcome was the interaction of latent class (clinical profile) and intervention group (FAST, SAM, FAST+SAM) on a change in steps-per-day. Key clinical characteristics to identify the latent classes included walking speed, walking endurance, balance self-efficacy, cognition, and area deprivation. RESULTS: Of the 190 participants with complete pre- and post-intervention data (mean [SD] age, 64 [12] years; 93 females [48.9%]), 3 distinct profiles of people with chronic stroke were identified. Class 1 had the lowest walking capacity (speed and endurance), lowest balance self-efficacy, and highest area deprivation, and the greatest change in step-activity when enrolled in SAM (mean = 1624, 95% CI = 426-2821) or FAST+SAM (mean = 1150, 95% CI = 723-1577]). Class 2 had walking capacity, baseline steps-per-day, and self-efficacy values between Class 1 and 3, and had the greatest change in step-activity when enrolled in SAM (mean = 2002, 95% CI = 1193-2811). Class 3 had the highest walking capacity, highest self-efficacy, and lowest area deprivation and the greatest change in step-activity when enrolled in FAST+SAM (mean = 1532, 95% CI = 915-2150). CONCLUSIONS: People with chronic stroke require different interventions to optimize changes in step-activity. RELEVANCE: Clinicians can use clinically relevant measures to personalize intervention selection to augment step-activity in people with chronic stroke.","journal":"Physical Therapy","year":2025,"id":544183,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.953,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":289294,"name":"Ryan T. Pohlig","orcid":"0000-0002-8385-8218","position":1,"is_corresponding":false},{"id":687530,"name":"Allison Miller","orcid":"0000-0003-3043-6852","position":2,"is_corresponding":false},{"id":986592,"name":"Elizabeth D. Thompson","orcid":"0000-0001-9808-4991","position":3,"is_corresponding":false},{"id":408286,"name":"Darcy S. Reisman","orcid":null,"position":4,"is_corresponding":false},{"id":1028519,"name":"Kiersten M. McCartney","orcid":"0000-0002-6304-9763","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:53:12.864581Z","pmid":"40360175","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}