Objectives To examine the relationship among 4 clinical measures of walking ability and the outputs of the StepWatch Activity Monitor in participants with stroke.

Design Correlational study.

Setting Clinic and participants' usual environments.

Participants Fifty participants more than 6 months after stroke were recruited. All participants were able to walk independently, but with some residual difficulty.

Interventions Not applicable.

Main Outcome Measures Rivermead Mobility Index (RMI), Rivermead Motor Assessment (RMA), six-minute walk test (6MWT), ten-meter walk test (10MWT), StepWatch outputs (based on daily step counts and stepping rates).

Results The correlations between the RMA and all StepWatch outputs were low (ρ=0.36–0.48; P<.05), as were most for the RMI (ρ=0.31–0.52; P<.05). The 10MWT and 6MWT had moderate to high correlations (ρ=0.51–0.73; P<.01) with most StepWatch outputs. Multiple regression showed that the 6MWT was the only significant predictor for most StepWatch outputs, accounting for between 38% and 54% of the variance. Age and the RMI were further significant predictors of 1 and 2 outputs, respectively.

Conclusions The 6MWT has the strongest relationship with the StepWatch outputs and may be a better test than the 10MWT to predict usual walking performance. However, it should be remembered that the 6MWT explains only half the variability in usual walking performance. Thus, activity monitoring captures aspects of walking performance not captured by other clinical tests and should be considered as an additional outcome measure in stroke rehabilitation.