High-Dose Walking Booster Program Is Feasible for People After Stroke: A Phase II Randomized Trial

Area of Science:

• Neurorehabilitation
• Motor Recovery
• Clinical Trials

Background:

• Maintaining long-term walking ability after stroke presents challenges.
• Access to consistent physiotherapy is often limited for stroke survivors.
• This study assessed the feasibility and outcomes of a high-dose walking intervention.

Purpose of the Study:

• To determine the feasibility of a clinical trial for a high-dose walking booster program (HiWalk).
• To measure key clinical outcomes related to mobility and self-efficacy post-stroke.
• To identify potential target populations for future stroke rehabilitation research.

Main Methods:

• A multisite, assessor-blinded pilot and feasibility randomized trial was conducted.
• Participants with chronic stroke received either HiWalk plus usual care or usual care alone.
• Feasibility was assessed by recruitment, retention, adherence, and safety; clinical outcomes included walking speed and self-efficacy.

Main Results:

• The HiWalk trial demonstrated feasibility with high retention (98%) and adherence (91%).
• A significant improvement in self-efficacy was observed at 1 month.
• While a small positive effect on fast walking speed was noted, significant differences were not found in the overall group; however, exploratory analysis showed benefits for those not undertaking rehabilitation.

Conclusions:

• The HiWalk program is a feasible community-based mobility training approach for stroke survivors.
• Benefits were observed in a subgroup of participants no longer receiving rehabilitation.
• Future research should prioritize this subpopulation to optimize walking recovery after stroke.