Resistive-based Walking Training For Individuals With Poststroke Hemiparesis

But did these people have spasticity or foot drop?
https://insights.ovid.com/medicine-science-sports-exercise/mespex/2018/05/001/resistive-based-walking-training-individuals/77/00005768

Christopher P. Hurt; Marcas M. Bamman; Tara Pearce; Sarah dos Anjos; Jutaluk Kongsuk; David A. Brown

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Excerpt

Individuals poststroke exhibit reduced walking economy compared to age-matched nonimpaired individuals. Typical aerobic training-based walking programs may not improve economy.
PURPOSE: This abstract describes the feasibility of applying backward directed resistive forces to individuals poststroke walking at their comfortable speed, at a vigorous level of aerobic intensity, within a novel treadmill environment.
METHODS: We are reporting on two participants (49±9 yrs, >6 months post CVA) who have completed the resistive walk training within this ongoing pilot RCT (NCT03174392). Individuals visited the lab 3 days a week for 8 weeks and accumulated 30 minutes of walking per training session. The training bouts were broken up into 5-minute increments, if needed, and resistive force was added until a training intensity of at least 60% heart rate reserve was achieved. Resistive forces were provided by a novel exercise training device that delivered a constant backward-directed pulling force at the level of the center of mass. Participants did not use handrails while training, however they wore a safety harness to ensure safety. Comfortable walk speed, 6-minute walk, and the Functional Gait Assessment (FGA) were completed along with net gait economy, pre-and post- training. Average standing VO2 consumption was subtracted from the final three minutes of a six-minute walking trial at the same speed pre- and post-assessment.
RESULTS: One individual began walking against a constant 19 N resistive force and progressed to 57N. Walking economy improved 11.5% with a marginal change in walking speed, however this individual increased their 6-minute walk distance 10% while improving their FGA score by 33%. The other individual progressed from 33 N to 85 N of continuous force. A 37% increase in economy occurred upon completion of the training with marginal changes in comfortable walking speed and a 34% improvement in 6-minute walk distance along with an 11% increase in FGA.
CONCLUSION: This preliminary data suggests that using horizontal resistive forces to generate an aerobic level of training during walking is a feasible approach to exercise training of individuals poststroke and may result in improved gait economy, balance, ability to sustain higher work at their comfortable speed, and endurance.