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Review
. 2016 Dec;29(6):677-683.
doi: 10.1097/WCO.0000000000000397.

Influence of skill and exercise training parameters on locomotor recovery during stroke rehabilitation

T George Hornby  1 , Jennifer L Moore, Linda Lovell, Elliot J Roth
Affiliations
Review

Influence of skill and exercise training parameters on locomotor recovery during stroke rehabilitation

T George Hornby et al. Curr Opin Neurol. 2016 Dec.

Abstract

Purpose of review: Research findings from the fields of motor learning and exercise physiology suggest specific training parameters that can be manipulated during physical rehabilitation profoundly influence skilled task performance. This review details the rationale for some of these training variables and their application in selected intervention studies focused on improving walking function in patients poststroke.

Recent findings: Basic and applied studies have shown that the amount, intensity, and variability of specific task practice applied during rehabilitation interventions can affect recovery of walking poststroke. Many studies detailing the effects of conventional, therapist, and mechanically assisted interventions may incorporate some of these training parameters but minimize others, and their relative contributions may influence walking outcomes. Specific patient factors, such as the stroke acuity and degree of impairments, appear to influence the relative contributions of these training variables, and different patient subgroups may benefit from greater emphasis on specific parameters.

Summary: The present findings suggest these training parameters should be considered when evaluating or implementing physical interventions directed toward improving locomotor function poststroke. More work is needed to understand their optimal combinations to maximize walking outcomes in patients with different levels of impairment poststroke.

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Conflict of interest statement

Conflicts of interest:

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Scatterplot of relations of A) amount of stepping practice (steps/session) and B) intensity of stepping practice (percentage of predicted peak HR reserve) on changes in gait speed in subacute stroke following high intensity stepping activity vs conventional (control) interventions (modified from (4)).
See this image and copyright information in PMC

References

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      ** Two recent studies that incorporate high intensity stepping practice in variable contexts and its influence on walking speed, distance and gait symmetry in chronic and subacute stroke and as compared to conventional strategy matched to an equivalent number of training sessions.

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