Your doctor needs to reconcile the HIT(High intensity training) that Andrew Marr blames for causing his stroke and this research. YOUR DOCTOR'S RESPONSIBILITY!
And your doctor will 100% guarantee that HIT will not cause a stroke? By verifying that your aneurysms will not blow out?
Do you really want to do high intensity training?
Because Andrew Marr blames high-intensity training for his stroke.
Can too much exercise cause a stroke?
The latest here:
Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
Journal of NeuroEngineering and Rehabilitation volume 19, Article number: 51 (2022)
Abstract
Background
Stroke is a leading cause of serious gait impairments and restoring walking ability is a major goal of physical therapy interventions. Soft robotic exosuits are portable, lightweight, and unobtrusive assistive devices designed to improve the mobility of post-stroke individuals through facilitation of more natural paretic limb function during walking training. However, it is unknown whether long-term gait training using soft robotic exosuits will clinically impact gait function and quality of movement post-stroke.
Objective
The objective of this pilot study was to examine the therapeutic effects of soft robotic exosuit-augmented gait training on clinical and biomechanical gait outcomes in chronic post-stroke individuals.
Methods
Five post-stroke individuals received high intensity gait training augmented with a soft robotic exosuit, delivered in 18 sessions over 6–8 weeks. Performance based clinical outcomes and biomechanical gait quality parameters were measured at baseline, midpoint, and completion.
Results
Clinically meaningful improvements were observed in walking speed (
< 0.05), suggesting biomechanical improvements in walking function.
Conclusions
The results in this study offer preliminary evidence that a soft robotic exosuit can be a useful tool to augment high intensity gait training in a clinical setting. This study justifies more expanded research on soft exosuit technology with a larger post-stroke population for more reliable generalization.
Trial registration This study is registered with ClinicalTrials.gov (ID: NCT04251091)
Introduction
Stroke is a leading cause of serious long-term disability [1], leaving the majority of those who survive with pervasive gait deficits such as reduced walking speed, decreased endurance, and atypical gait patterns [2]. Improving walking ability is a high-rated priority for individuals following a stroke, and a major goal of physical therapy interventions [3].
One of the emerging therapeutic regimens to improve functional outcomes after stroke involves high intensity gait training with the focus on higher cardiovascular intensities [4]. Indeed, previous studies suggested that the amount and intensity of stepping training are related to gains in walking speed and endurance [5]. This strategy currently is primarily focused on improving functional locomotor capacity, with less quality of movements [6]. The potential neglect of control in quality of movements during the training may lead to persistence of gait impairments such as spatiotemporal asymmetries and gait compensations [7, 8], ultimately resulting in a metabolically inefficient gait [9] and an increased risk of falling [10].
Soft robotic exosuits are portable, lightweight, and unobtrusive assistive devices made from garment-like functional textiles, cable-based actuators and wearable sensors to improve the mobility of post-stroke individuals through facilitation of more normal paretic limb function during walking [11,12,13]. Previous studies have demonstrated strong evidence of the immediate gait restorative effects using soft robotic exosuits on post-stroke individuals. For instance, prior foundational studies reported improvements in the mechanics and energetics of post-stroke hemiparetic walking as well as clinical outcomes (i.e., walking speed and endurance) with assistance provided to the paretic ankle in plantarflexion and dorsiflexion by a soft robotic exosuit [12,13,14,15]. A recent Robotic Exosuit Augmented Locomotion (REAL) trial conducted a high-intensity, task-specific, and progressively challenging walking training protocol with soft robotic assistance and demonstrated improvements both in clinical and biomechanical outcomes after 5 days of training on a single post-stroke individual [16]. Another recent multi-site clinical study tested a commercially- and clinically-available soft exosuit on post-stroke participants and reported increased maximum walking speed after five sessions of training [17]. These studies showed initial evidence that a single-session, acute restorative effects can be further leveraged to improvements when the soft exosuit is used with gait training in a short-term period. However, at present, it is uncertain how the longer duration (matching outpatient therapy models) of high intensity gait training augmented with soft exosuit will impact traditional clinical measures and biomechanical quality of gait movements post-stroke.
The objective of this pilot intervention study was to examine the rehabilitative effects of soft robotic exosuit-augmented gait training on clinical and biomechanical outcomes of gait in post-stroke individuals. We conducted 18 training sessions of high intensity gait training using a soft exosuit on five individuals in the chronic phase of post-stroke recovery. The main clinical outcomes of the intervention were improving walking speed and endurance as they are the primary walking goals of the physical therapy intervention after stroke [18, 19]. The secondary outcomes were the gait quality measures including spatiotemporal characteristics and joint kinematics to evaluate changes in gait impairments throughout the intervention. We hypothesized that this combined training would improve the traditional clinical outcomes together with biomechanical gait quality measures due to the synergistic effect of training on both intensity and quality of movements.
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