BIG STEPS for Stroke

(BIG STEPS Trial)

This trial aims to help stroke survivors improve daily movement and reduce sitting time, potentially enhancing recovery and quality of life. Participants will replace sitting with more steps, and researchers will track their progress over a year. The trial is suitable for individuals aged 50 and older who have had a stroke in the past three months, have recently left the hospital, and can walk five meters, even with assistance. Researchers will compare two groups: one begins the movement program immediately, while the other waits six months. The goal is to determine the optimal timing for interventions to maximize recovery benefits. As an unphased trial, this study offers participants the chance to contribute to valuable research that could improve recovery strategies for future stroke survivors.

A previous study, the BIG STEPS program, combined behavior change with stepping exercises and proved both practical and safe for stroke patients. Participants in that study demonstrated promising early results without major safety concerns. This suggests the program is well-tolerated and poses no significant risks to participants.

Researchers are excited about the BIG STEPS intervention for stroke recovery because it focuses on transforming sedentary behaviors into active stepping, tailored to each individual's baseline activity. Unlike traditional rehabilitation methods that might not prioritize everyday movement changes or are often standardized, this approach personalizes goals using accelerometry data to encourage consistent and specific increases in physical activity. By starting this intervention within three months post-stroke, the aim is to harness the critical early recovery period, potentially leading to better long-term mobility and health outcomes.

Research has shown that walking more each day and sitting less can aid recovery after a stroke. Studies have found that taking more steps can increase walking speed and duration, enhancing overall mobility. For instance, one study found that more intense walking training improved walking distance and speed. Another study demonstrated that more intensive rehabilitation could enhance the quality of life for stroke survivors. In this trial, participants will engage in the BIG STEPS intervention, which focuses on behavior and guided stepping training. The trial includes two arms: the Early BIG STEPS group, where participants start the intervention within 3 months of stroke onset, and the Delayed BIG STEPS group, where participants begin after 6 months. Overall, walking exercises appear to help stroke patients move better and improve their daily activities.⁶⁷⁸⁹¹⁰