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Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
Higher Heart Rates During Locomotor High-Intensity Interval Training Are Associated With Gait Asymmetry and Fatigue
Alicen A Whitaker-Hilbig1,2, Pierce Boyne3, Darcy S Reisman4
1Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI.
Cardiopulmonary Physical Therapy Journal
|May 28, 2026
Summary
Post-stroke individuals with severe hemiparesis may struggle with high-intensity interval training (HIIT). Early in training, less walking symmetry and more fatigue correlated with higher intensity, but these associations disappeared over time.
Area of Science:
- Neurology
- Cardiovascular Rehabilitation
- Exercise Physiology
Background:
- Individuals poststroke with severe hemiparesis often experience deconditioning, limiting their ability to engage in vigorous cardiovascular exercise like high-intensity interval training (HIIT).
- Assessing the relationship between baseline walking function and the ability to achieve target cardiovascular intensity during locomotor HIIT is crucial for tailoring rehabilitation programs.
Purpose of the Study:
- To investigate the association between baseline walking function and the average percent heart rate reserve (%HRR) achieved during locomotor high-intensity interval training (HIIT) in individuals poststroke.
- To determine if initial walking impairments predict cardiovascular intensity during the initiation of HIIT.
Main Methods:
- Twenty-seven individuals poststroke underwent baseline assessments including walking endurance (6-min walk test), walking speed (10-m walk), gait symmetry (electronic walkway), and metabolic cost of fast walking.
- Cardiovascular intensity during treadmill HIIT (30s maximal walking, 30-60s recovery, 3x/week) was measured by %HRR.
- Covariates included peak heart rate, respiratory exchange ratio, and self-reported fatigue.
Main Results:
- Less baseline walking step length symmetry and greater baseline fatigue were associated with higher cardiovascular intensity (%HRR) during the first week of locomotor HIIT.
- These associations between baseline walking characteristics and achieved HIIT intensity were no longer significant after 12 weeks of training.
Conclusions:
- Few baseline walking characteristics predicted cardiovascular intensity during the initiation of locomotor HIIT, possibly due to high heart rate variability.
- As individuals progressed and adapted to HIIT, baseline factors became less influential in determining achieved cardiovascular intensity.
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