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. 2019 Feb 13;9(1):1985.
doi: 10.1038/s41598-018-37982-w.

Effects of High Intensity Speed-Based Treadmill Training on Ambulatory Function in People With Chronic Stroke: A Preliminary Study With Long-Term Follow-Up

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Free PMC article

Effects of High Intensity Speed-Based Treadmill Training on Ambulatory Function in People With Chronic Stroke: A Preliminary Study With Long-Term Follow-Up

Sangeetha Madhavan et al. Sci Rep. .
Free PMC article

Abstract

High intensity treadmill training has shown to be beneficial for stroke survivors, yet the feasibility and long-term effects remain unclear. In this study, we aimed to determine whether a 4-week high intensity speed-based treadmill training (HISTT) is feasible for chronic stroke survivors, and we examined its effects on ambulatory function, and long-term retention. Sixteen individuals post-stroke participated in 40 minutes of HISTT for four weeks at a frequency of three sessions per week. Gait speed was measured using the 10-meter walk test, endurance was measured using the 6-minute walk test, and quality of life was assessed using the Stroke Impact Scale (SIS) at baseline, post-training, and at 3-month follow-up. All participants successfully completed the training without any serious adverse events. Participants significantly increased fastest walking speed by 19%, self-selected walking speed by 18%, and walking endurance by 12% after the training. These improvements were maintained for 3 months after the intervention. Our results indicate that this modified speed-based high intensity walking program has the potential to be a feasible and effective method of gait training for stroke survivors. However, the small sample size and lack of a control group warrant caution in interpretation of results. Further studies are recommended to better understand effectiveness of this protocol in combination with other physical therapy interventions for functional recovery after stroke.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Representative example from one participant during a single session of high intensity speed-based treadmill training (HISTT). Interval heart rate (circles), recovery heart rate (diamonds), highest treadmill speed achieved during each interval (triangles), and accumulated distance walked (squares) are shown. Heart rate (beats per minute) is represented on the left primary y-axis. Peak treadmill speed (miles per hour) and distance (miles) are represented on the right secondary y-axis. The x-axis represents the number of intervals achieved.
Figure 2
Figure 2
Average percent changes of self-selected walking speed (circles), fastest walking speed (triangles), and 6-minute walking distance (squares) from PRE to POST and 3-MON. Error bars indicate standard error of mean. *Significantly different than PRE (p < 0.05).
Figure 3
Figure 3
Changes in mean heart rate (circles), overground fastest walking speed (triangles), and peak treadmill speed (squares) by week. Mean heart rate (beats per minute) during speed-based intervals is represented on the left primary y-axis. Overground fastest speed and peak treadmill speed (metres per second) are represented on the right secondary y-axis. The x-axis represents the four different weeks. Error bars indicate standard error of mean.
Figure 4
Figure 4
Schematic of a single session high intensity speed-based treadmill training (HISTT). HISTT involved 40 minutes of treadmill walking: 5-minute warm-up, 30-minute speed-based training intervals, and 5-minute cool down. The training consists of multiple 2-minute speed-based intervals alternated with 2-minute active recovery periods. During the speed-based training intervals, the belt speed is gradually increased to the participant’s tolerable highest speed (*) and maintained for 10 seconds. The recovery requires the participant to walk at warm-up/cool down speeds until the heart rate recovers to warm-up level.

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