High-Intensity Gait Training for Patients After Stroke: A Feasibility Study

BACKGROUND AND PURPOSE: Approximately two-thirds of stroke patients experience various levels of walking impairment that limit their participation in society. Mounting evidence suggests that gait training provided at high cardiovascular intensity with a focus on stepping practice improves gait function after stroke and is superior to lower intensity standard gait training. However, high intensity gait training (HIGT) is not widely applied.

PURPOSE: With this study, we wanted to examine the feasibility of HIGT in a XXX neurorehabilitation hospital.

METHODS: A longitudinal cohort study with 15 patients participated in 2 weeks of HIGT with 3-5 sessions per week. HIGT was provided as part of standard physical therapy. The results included feasibility measures such as adherence and fidelity to treatment, adverse events, and patient satisfaction. Furthermore, gait assessments were performed before and after the intervention and heart rate and number of steps were monitored during the training sessions.

RESULTS: Eleven of the 15 patients were non-ambulatory or dependent on the support of two people at the start of HIGT. Adherence to treatment was good, with almost all (14/15) completing 8 sessions or more. No serious adverse events occurred. The target heart rate of > 60% of HRmax was achieved for a mean of 26.4, SD 7.4, min-max 12.3-37.0 min per session. The number of steps increased from 245.44 (SD 223.12) in the first session to 676.75 (SD 376.83) in the last session. However, with a large variety, both within and between individuals. There was a significant improvement in all gait assessments. Patient satisfaction was high.

DISCUSSION: HIGT was feasible, well tolerated by the patients and could be provided within existing staffing levels. There were no serious adverse events, and all patients confirmed that they would recommend HIGT to a friend in the same situation.