Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study.
OBJECTIVE
To investigate the feasibility and the effects on gait of a high intensity task-oriented training, incorporating a high cardiovascular workload and large number of repetitions, in patients with subacute stroke, when compared to a low intensity physiotherapy-programme.


METHODS
Randomized controlled clinical trial: Forty-four patients with stroke were recruited at 2 to 8 weeks after stroke onset.


METHODS
Maximal gait speed assessed with the 10-metre timed walking test (10MTWT), walking capacity assessed with the six-minute walk test (6MWT). Control of standing balance assessed with the Berg Balance Scale and the Functional Reach test. Group differences were analysed using a Mann-Whitney U-test.


RESULTS
Between-group analysis showed a statistically significant difference in favour of the high intensity task-oriented training in performance on the 10MTWT (Z = -2.13, P = 0.03) and the 6MWT (Z = -2.26, P = 0.02). No between-group difference were found for the Berg Balance Scale (Z = -0.07, P = 0.45) and the Functional Reach test (Z = -0.21, P = 0.84).


CONCLUSIONS
A high-intensity task-oriented training programme designed to improve hemiplegic gait and physical fitness was feasible in the present study and the effectiveness exceeds a low intensity physiotherapy-programme in terms of gait speed and walking capacity in patients with subacute stroke. In a future study, it seems appropriate to additionally use measures to evaluate physical fitness and energy expenditure while walking.
Outermans
Jacqueline C
JC
Department of Physiotherapy, Institute for Human Movement Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands. jacqueline.outermans@hu.nl
van Peppen
Roland P S
RP
Wittink
Harriet
H
Takken
Tim
T
Kwakkel
Gert
G
D002320:Cardiovascular Physiological Phenomena; D004734:Energy Metabolism; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology; D012143:Respiratory Physiological Phenomena; D018709:Statistics, Nonparametric; D020521:Stroke / Q000378:metabolism / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*