Intense Step Training May Improve Walking, Balance After Stroke

Fucking useless. 'May' NOT protocols means they don't know specifics and their mentors and senior researchers need to be keel-hauled.  This is where I suggest a couple of drinks on a high bar stool and then walk thru a crowd to the bathroom. That would be intensely challenging and more likely to improve your walking and balance quickly. Don't do this, I'm not medically trained and thus obviously know nothing about stroke. Which is why no stroke medical professional has ever contacted me.

Intense Step Training May Improve Walking, Balance After Stroke

High-intensity step training that mimics real-world conditions could better promote walking ability after a patient experiences a stroke compared with traditional, low-impact training, new research suggests.
In a study of 90 patients who had weakness on one side of the body after experiencing a stroke 6 months previously, high-intensity step training was associated with greater improvements in both walking ability and gait symmetry than low-intensity training, with potentially greater improvements in balance confidence.
High-intensity variable training also resulted in improved dynamic balance while walking.
"What we found is that if you do both the high-intensity training and the variable practice, then you really get gains in both walking and balance and balance confidence," lead investigator T. George Hornby, PhD, professor of physical medicine and rehabilitation at Indiana University School of Medicine, Indianapolis, told Medscape Medical News.

The findings were published online August 22 in Stroke.

Function Over Form

The study's goal was to determine both the individual and combined contributions of intensity and variability of stepping practice to improving walking speed and distance in people who had experienced stroke.
Accumulating data suggest that traditional rehabilitation practices, which emphasize normalizing gait patterns through low-intensity exercises, produce only limited improvements in mobility. Some studies have shown that increasing exercise intensity can improve walking endurance, but this did not necessarily improve balance or the ability to perform transfers.

For the current study, researchers hypothesized that instead of training stroke patients on forward walking or with low-intensity training in stepping tasks, ramping up both the intensity and the variability of stepping practice may yield real improvement in mobility and balance.
"We need to probably simulate the tasks that people will do in the real world," said Hornby. "What we're doing in the study is essentially trying to recapitulate that in some sense, in that we do these really variable tasks that are really challenging the patient."
In this randomized, blinded, phase 2 trial, the investigators screened 152 patients aged 18 to 85 years who had experienced post-stroke hemiparesis for a period of 6 or more months.
Of those patients, 97 were randomly assigned to one of three training groups: a high variable group, which performed high-intensity, variable, difficult stepping tasks that required 70% to 80% of heart rate reserve; a high forward group, which performed high-intensity stepping but only forward walking; and a low variable group, which performed low-intensity stepping in variable contexts at 30% to 40% of heart rate reserve.

Variable tasks included walking on uneven surfaces, up inclines and stairs, over randomly placed obstacles on a treadmill, and across a balance beam.