Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke

T. Hornby, Donald Straube, Catherine Kinnaird, Carey Holleran, Anthony Echauz, Kelly Rodriguez, Eric Wagner, Elizabeth Narducci

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

The majority of individuals poststroke recover the ability to walk overground, although residual impairments contribute to reduced walking speed, spatiotemporal asymmetries, inefficient gait, and limited walking activity in the home and community. A substantial number of studies have investigated the effects of various interventions on locomotor function in individuals poststroke; these studies vary widely in types of tasks practiced, the amount of practiced activities, and the intensity or workload during the intervention. In contrast, basic and applied studies have identified specific parameters of training that could be applied towards treatment of patients poststroke. More directly, the specificity, amount, and intensity of walking practice are thought to be critical variables of rehabilitation interventions that can facilitate plasticity of neuromuscular and cardiopulmonary systems and result in improved locomotor function. In the present commentary, we delineate the evidence and physiological rationale for providing large amounts of high-intensity locomotor training to improve ambulatory function in individuals poststroke. Additional evidence is presented to indicate that improvements in non-walking tasks, such as static balance and performance of transfers, may also occur following locomotor training. We further evaluate previous and more recent studies in the context of these parameters and provide suggestions for providing locomotor training for patients with stroke in the clinical setting.

Original languageEnglish
Pages (from-to)293-307
Number of pages15
JournalTopics in stroke rehabilitation
Volume18
Issue number4
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Keywords

  • gait training
  • intensity
  • locomotion

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