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.

Thursday, October 1, 2026

A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial

 Did your competent? doctor get you recovered enough to do this fast walking?

NO? So, PURE INCOMPETENCE THEN!

My doctor knew nothing about recovery and did nothing. Which is why my gait is still screwed up; 15 degree leftward angle of left foot, no push-off, no free swinging lower leg, hyperextension of left knee. Can't do fast walking until these are fixed or I'll destroy my left knee.

This will never occur in your hospital, too worried about you falling. 

A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial


Margaret Danilovich, Daniel S. Rubin David E. Conroy, Laura Diaz, Ying Cheung, Lauren Balmert Bonner 
Published: September 30, 2026 https://doi.org/10.1371/journal.pone.0357605

Abstract

Interventions to reduce frailty and promote healthy aging are critical to improving quality of life and reducing disability in older adults. Walking is the most common form of exercise among older adults; however, the optimal walking intensity for prefrail and frail adults remains unclear. We conducted a cluster-randomized, assessor- and participant-blinded trial to determine whether high-intensity walking (HIW) improves frailty more than casual-speed walking (CSW). Fourteen retirement communities were randomized to either HIW or CSW using a modified minimal sufficient balance randomization scheme. We recruited 165 prefrail and frail adults aged ≥60 years, of whom 105 were included in the analytic cohort. Participants were able to ambulate at least 10 feet with moderate assistance or less. The HIW group targeted 70% of heart rate maximum (HRmax), while the CSW group walked at self-selected speeds below 60% HRmax. Supervised walking sessions were 45 minutes, three times per week, for 16 weeks. The primary outcome was improvement by at least one frailty category on the SHARE-FI (Survey of Health Among Retired Europeans – Frailty Index). Secondary outcomes included the Timed Up and Go, Short Physical Performance Battery, Berg Balance Scale, and 6-Minute Walk Test (6MWT), measured at baseline and 16 weeks. Participants had a mean (SD) age of 79.2 (8.0) years; 79% were female, and 75% were non-Hispanic White. Improvement in frailty category occurred in 32 of 46 (69.6%) HIW participants versus 26 of 56 (46.4%) CSW participants (OR = 2.91, 95% CI 1.19–7.13, p = 0.02). HIW participants showed greater gains in gait speed (mean difference = 0.08 m/s, 95% CI 0.03–0.13, p = 0.036) and 6MWT distance (mean difference = 48.99 m, 95% CI 21.1–76.9, p = 0.0088). Mean HRmax was 71% in HIW vs. 59% in CSW (p < 0.001). Median completed sessions were similar (HIW = 35; CSW = 36; p = 0.07). This cluster-randomized trial demonstrates that high-intensity walking can reverse frailty more effectively than casual-speed walking due to increased physiologic stimuli during more intensive activity. This study is registered at ClinicalTrials.gov ID NCT03654807 (https://clinicaltrials.gov/study/NCT03709251) Registered 10/12/2018.

Citation: Danilovich M, Rubin DS, Conroy DE, Diaz L, Cheung Y, Corcos D, et al. (2026) A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial. PLoS One 21(9): e0357605. https://doi.org/10.1371/journal.pone.0357605

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