Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, August 20, 2025

FAST walk shows promise in improving gait for chronic stroke patients

This wouldn't help persons like me who have spasticity preventing pushoff and correct heel strike. Without curing spasticity this does no good for me. And with my premotor cortex gone hyperextending the knee occurs, so another problem this doesn't solve. 

 FAST walk shows promise in improving gait for chronic stroke patients


Stroke remains one of the leading causes of long-term disability worldwide, affecting millions each year. Among its most debilitating consequences is gait impairment, which affects over 80% of stroke survivors. Impaired walking not only reduces independence but also limits participation in daily and social activities, significantly diminishing the quality of life. While some patients regain partial ambulatory function, walking speed and coordination often remain impaired. Alarmingly, up to 22% of survivors never regain the ability to walk and are confined to indoor or severely limited community ambulation.

Physical rehabilitation is essential for post-stroke gait recovery. Conventional therapies such as therapist-assisted walking, treadmill training, and strength exercises offer benefits but often fail to fully restore efficient and functional gait in patients with chronic stroke. As a result, there is a growing interest in non-invasive neuromodulation techniques to enhance neuroplasticity and support motor recovery.

In an effort to address the ongoing challenge of gait impairment after stroke, researchers have developed an innovative rehabilitation approach known as FAST walk. This study was led by Professor Toshiyuki Fujiwara and Dr. Mami Tani from the Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Japan. Prof. Fujiwara explains, "More than 80% of stroke survivors experience gait disturbances. Particularly, reduced gait speed limits outdoor mobility and makes it difficult for individuals to return to work. Walking is a complex function, controlled by spinal neural circuits that respond to commands from the brain. To address this, we developed the FAST walk system to support gait rehabilitation in patients with post-stroke impairments." The findings were published in Volume 22 of the Journal of NeuroEngineering and Rehabilitation on July 07, 2025.

FAST walk is an innovative, electromyography (EMG)-triggered system that synchronizes transcutaneous spinal cord stimulation with hip extensor stimulation. This dual approach uses the patient's own muscle signals to stimulate precisely during key gait phases. By enhancing the spinal circuit excitability and activating reflexes such as the crossed extensor reflex, the system aims to improve lower limb coordination and gait efficiency.

To evaluate the clinical potential, researchers conducted a randomized controlled trial involving three groups: FAST walk, spinal stimulation alone, and treadmill training. Each group received two gait training sessions per week for five weeks (10 sessions in total). The study's design was shaped by Japan's healthcare regulation, which limits rehabilitation to 260 minutes per month, making this research especially relevant to time-constrained, real-world settings.

All groups demonstrated improvements in walking speed that exceeded the minimum clinically important difference for chronic stroke (0.15 m/s). Specifically, the FAST walk group improved from 0.55 m/s to 0.70 m/s, the spinal stimulation group from 0.90 to 1.16 m/s, and the treadmill group from 0.90 to 1.09 m/s. However, only the FAST walk group showed a statistically significant improvement in gait speed within groups, suggesting that the combined stimulation may offer added benefit over either approach alone.

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