Related Experiment Video
Updated: Jul 8, 2026
Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
Predicting Walking Capacity Outcomes After Moderate-to-High Intensity Locomotor Training in Chronic Stroke
Christina Garrity1, Darcy S Reisman, Sandra A Billinger
1Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio (C.G., P.B.); Department of Physical Therapy, University of Delaware, Newark, Delaware (D.R., K.B.); Department of Neurology (S.B.), Department of Cell Biology and Integrative Physiology (S.B.), Department of Physical Medicine and Rehabilitation (S.B.), School of Medicine, University of Kansas Medical Center, Kansas City, Kansas; and University of Kansas Alzheimer's Research Disease Center, Fairway, Kansas (S.B.).
Purpose:
Moderate-to-high intensity locomotor training (M-HIT) is strongly recommended in stroke rehabilitation, but outcomes are variable. This study aimed to identify baseline clinical characteristics that predict changes in walking capacity following M-HIT in chronic stroke.
Methods:
This analysis used data from the HIT-Stroke Trial ( N = 55), which involved up to 36 sessions of either moderate- or high-intensity locomotor training. A prespecified model assessed how well baseline motor impairment (Fugl-Meyer lower limb motor scale [FM-LL]), comfortable gait speed (CGS), and balance confidence (Activities-specific balance confidence scale [ABC]) independently explain changes in 6-minute walk distance (∆6MWD), while controlling for the treatment group. Exploratory analysis tested additional baseline covariates using the all-possible regressions procedure. The predictive value of each potential covariate was assessed by its average contribution to the explained variance in ∆6MWD (∆pseudo- R2 ).
Results:
With the prespecified model, 8-week ∆6MWD was significantly associated with baseline FM-LL (β = 5.0 [95% CI: 1.4, 8.6]) and ABC (β = 0.7 [0.0, 1.4]), but not CGS (β = - 44.6 [-104.7, 15.6]). The exploratory analysis revealed that the top 7 covariates with the highest mean ∆pseudo- R2 were FM-LL, pain-limited walking duration, ABC, the use of an assistive device, fatigue, depression, and recent walking exercise history >2 days per week.
Discussion And Conclusions:
On average, participants with less motor impairment and higher balance confidence exhibit greater walking capacity improvements after M-HIT in chronic stroke. Additional negative predictive factors may include pain-limited walking duration, use of an assistive device, fatigue, depression, and recent walking exercise; however, these exploratory findings need to be confirmed in future studies.
Video Abstract:
Supplemental Digital Content available at [ http://links.lww.com/JNPT/A533 ].
