I was only challenged once while doing in-hospital rehab when my therapist took me outside to walk on grass and down a small hill. I vastly expanded the difficulty when I got home. I bet your therapists won't do this for their patients for decades, fear of having patients fall will prevent it from occurring.
I'm sure your therapists and doctors did nothing with this from April 2017. You should call the stroke hospital president and ask when competent stroke professionals will be hired. I would include the president and board of directors in that description.
Step training improves reaction time, gait and balance and reduces falls in older people: A systematic review and meta-analysis April 2017
The latest here:
High-intensity step training boosts stroke survivors' walking skills
Stroke Journal Report
DALLAS, Aug. 22, 2019 -- High-intensity step training that mimics
real-world conditions may better improve walking ability in stroke
survivors compared to traditional, low-impact training, according to new
research published in the American Heart Association's journal Stroke.
"People who suffer strokes often have difficulty walking and impaired balance. Rehabilitation after a stroke traditionally focuses on patients practicing low-intensity walking, usually only in a forward direction, which does not provide enough of a challenge to the nervous system to enable patients to negotiate real-world situations, such as uneven surfaces, stairs or changing direction," said study author T. George Hornby, Ph.D., professor of physical medicine and rehabilitation at Indiana University School of Medicine in Indianapolis. "Our study suggests that stroke patients can perform higher intensity walking exercises and more difficult tasks than previously thought possible. We need to move beyond traditional, low-intensity rehabilitation to challenge the nervous and cardiovascular systems so patients can improve function and perform better in the real world."
Researchers evaluated 90 people, 18- to 85-years-old with weakness on one side of the body who had survived a stroke at least six months prior.
Participants received training of either high-intensity stepping performing variable, difficult tasks; high-intensity stepping performing only forward walking; or low-intensity stepping of variable tasks. Variable tasks included walking on uneven surfaces, up inclines and stairs, over randomly placed obstacles on a treadmill and across a balance beam.
The researchers found:
"Rehabilitation that allows walking practice without challenging the nervous system doesn't do enough to make a statistical or clinically significant difference in a patient's recovery after a stroke," Hornby said. "We found that when stroke patients are pushed harder, they see greater changes in less time, which translates into more efficient rehabilitation services and improved mobility."
Ultimately, their goal is to incorporate high-intensity variable step training into regular clinical rehabilitation protocols.
The study was small compared to larger, multicenter clinical trials. Hornby said the next step would be to test high-intensity, variable step training in larger patient populations in a large, multicenter clinical trial.
The National Institute on Disability, Independent Living and Rehabilitation Research and the National Institute of Neurological Disorders and Stroke funded the study.
Additional Resources:
Available multimedia is on right column of release link - https:/
After Aug. 22, view the manuscript online.
Many stroke survivors don't receive timely rehab
Exercise can significantly improve brain function after stroke
American Stroke Association Policy Statement: New recommendations for stroke systems of care to improve patient outcomes
Follow AHA/ASA news on Twitter @HeartNews
"People who suffer strokes often have difficulty walking and impaired balance. Rehabilitation after a stroke traditionally focuses on patients practicing low-intensity walking, usually only in a forward direction, which does not provide enough of a challenge to the nervous system to enable patients to negotiate real-world situations, such as uneven surfaces, stairs or changing direction," said study author T. George Hornby, Ph.D., professor of physical medicine and rehabilitation at Indiana University School of Medicine in Indianapolis. "Our study suggests that stroke patients can perform higher intensity walking exercises and more difficult tasks than previously thought possible. We need to move beyond traditional, low-intensity rehabilitation to challenge the nervous and cardiovascular systems so patients can improve function and perform better in the real world."
Researchers evaluated 90 people, 18- to 85-years-old with weakness on one side of the body who had survived a stroke at least six months prior.
Participants received training of either high-intensity stepping performing variable, difficult tasks; high-intensity stepping performing only forward walking; or low-intensity stepping of variable tasks. Variable tasks included walking on uneven surfaces, up inclines and stairs, over randomly placed obstacles on a treadmill and across a balance beam.
The researchers found:
- Survivors in both the high-intensity, variable training and high-intensity, forward walking groups walked faster and farther than the low-intensity, variable training group.
- For all walking outcomes, 57% to 80% of participants in the high-intensity groups had important clinical gains, while only 9% to 31% of participants did so following low-intensity training.
- High-intensity variable training also resulted in improved dynamic balance while walking and improved balance confidence.
"Rehabilitation that allows walking practice without challenging the nervous system doesn't do enough to make a statistical or clinically significant difference in a patient's recovery after a stroke," Hornby said. "We found that when stroke patients are pushed harder, they see greater changes in less time, which translates into more efficient rehabilitation services and improved mobility."
Ultimately, their goal is to incorporate high-intensity variable step training into regular clinical rehabilitation protocols.
The study was small compared to larger, multicenter clinical trials. Hornby said the next step would be to test high-intensity, variable step training in larger patient populations in a large, multicenter clinical trial.
###
Co-authors are Christopher E. Henderson, Ph.D.; Abbey Plawecki,
D.P.T.; Emily Lucas, B.S.; Jennifer Lotter, D.P.T.; Molly Holthus,
D.P.T.; Gabrielle Brazg, D.P.T.; Meghan Fahey, D.P.T.; Jane Woodward,
D.P.T.; Marzieh Ardestani, Ph.D.; and Elliot J. Roth, M.D. Authors
report no disclosures.The National Institute on Disability, Independent Living and Rehabilitation Research and the National Institute of Neurological Disorders and Stroke funded the study.
Additional Resources:
Available multimedia is on right column of release link - https:/
After Aug. 22, view the manuscript online.
Many stroke survivors don't receive timely rehab
Exercise can significantly improve brain function after stroke
American Stroke Association Policy Statement: New recommendations for stroke systems of care to improve patient outcomes
Follow AHA/ASA news on Twitter @HeartNews
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