Individual-situation interactions influencing walking activity in post-stroke patients: an ecological momentary assessment study

Background Walking activity is highly dynamic and shaped by the continuous interplay between personal characteristics and situational contexts. However, most evidence in post-stroke patients has relied on retrospective questionnaires and has focused on main effects, with limited attention to whether individual traits moderate situational effects. Understanding these person–situation interactions is a prerequisite for developing precise, context-sensitive interventions. Methods This study employed a 7-day ecological momentary assessment design. Post-stroke patients in the recovery phase were recruited by convenience sampling. Individual traits (self-control and self-regulatory fatigue) were assessed at baseline via questionnaires. Situational factors—time of day, weather, physical location, social environment, and stress—were captured through smart wristbands and five daily ecological questionnaires, while walking activity (step count and duration of moderate-to-high-intensity activity) was continuously monitored by wrist-worn devices. Three-level generalized linear mixed models were constructed to examine the main effects of situational factors and the moderating effects of individual traits. Results Of the 154 patients recruited, 130 completed the study (dropout rate 15.6%), yielding 4,550 valid data points. Walking activity was generally insufficient and highly variable; Analysis using generalized linear mixed models showed that the outdoor environment, work status, and social status significantly promoted walking activity, while stress levels, high temperatures, and nighttime hours significantly inhibited walking activity. Individual traits exert a moderating effect on certain situational factors: self-control negatively moderates the effect of work status on step count; self-control buffers the negative effect of stress on the duration of moderate-to-vigorous physical activity. Conclusion Walking activity in post-stroke patients during the recovery phase was generally insufficient and strongly context-dependent. Outdoor environments, social states, and working states facilitated walking activity, whereas stress, high temperature, and nighttime periods inhibited it. Some of these situational effects are moderated by the level of self-control. The findings support the person–situation interaction theory and provide a mechanism-based foundation for developing precise, context-sensitive interventions to promote walking activity after stroke.