Effects of a 12-Week Moderate-to-High Intensity Strength Training Program on the Gait Parameters and Their...

Chronic stroke survivors often regain walking speed but continue to exhibit heightened gait variability, increasing fall risk. This study investigated the effects of a 12-week moderate-to-high intensity muscle strengthening program on gait parameters and their variability in stroke survivors, without incorporating gait-specific training.

Stroke survivors participated in a twice-weekly, 45-60 min strengthening program using Pilates equipment. Spatiotemporal gait parameters were measured before and after the intervention using 3D motion capture. Walking speed, cadence, step/stride length, step width, and various temporal parameters were analyzed for both paretic and non-paretic limbs, along with their coefficients of variation (CV). Correlation analyses were performed to understand the relationships between parameter changes.

Eleven patients (age 61 ± 7.4 years, 9 males) participated in the study. Significant improvements were observed in walking speed for both paretic (0.61 to 0.69 m/s, p = 0.032) and non-paretic limbs (0.62 to 0.69 m/s, p = 0.024). Step length significantly increased in the paretic limb (0.36 to 0.41 m, p = 0.042) with a substantial reduction in variability (CV: 19.91% to 14.99%). Cadence increased significantly in the non-paretic limb (89.24 to 92.01 steps/min, p = 0.024). Correlation analysis revealed distinct adaptation patterns between limbs, with speed improvements strongly associated with stride length in both limbs, but with step length only in the non-paretic limb.

A moderate-to-high intensity strengthening program, even without direct gait training, can improve walking speed and reduce movement variability in chronic stroke survivors. The intervention predominantly influenced the spatial parameters, with modest changes in the temporal aspects, suggesting that enhanced force production and control primarily affect step execution while preserving temporal gait patterns.