Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, June 12, 2018

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

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.

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