Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Physical Therapy

Background:

• Subacute stroke frequently results in impaired gait and reduced physical capacity.
• Task-oriented training (TOT) is a common rehabilitation strategy for stroke survivors.
• Optimizing the intensity and methodology of TOT is crucial for maximizing functional recovery.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of high-intensity task-oriented training (HI-TOT) in patients with subacute stroke.
• To compare the effects of HI-TOT with a low-intensity physiotherapy program on gait parameters and physical function.
• To assess the impact of HI-TOT on gait speed, walking capacity, and standing balance.

Main Methods:

• A randomized controlled trial involving 44 patients with subacute stroke (2-8 weeks post-onset).
• Intervention groups: High-intensity task-oriented training (high cardiovascular workload, high repetitions) vs. low-intensity physiotherapy.
• Outcome measures: 10-meter timed walking test (10MTWT) for gait speed, 6-minute walk test (6MWT) for walking capacity, Berg Balance Scale (BBS) and Functional Reach Test (FRT) for balance.

Main Results:

• HI-TOT group demonstrated statistically significant improvements in the 10MTWT (P=0.03) and 6MWT (P=0.02) compared to the low-intensity group.
• No significant differences were observed between groups for the Berg Balance Scale (P=0.45) or the Functional Reach Test (P=0.84).
• The high-intensity program was feasible for patients in the subacute stroke phase.

Conclusions:

• High-intensity task-oriented training is a feasible and effective intervention for improving gait speed and walking capacity in subacute stroke patients.
• HI-TOT demonstrates superior outcomes compared to low-intensity physiotherapy for specific gait-related functional measures.
• Future research should incorporate measures of physical fitness and energy expenditure to further elucidate the benefits of HI-TOT.