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Variable Intensive Early Walking Poststroke (VIEWS): A Randomized Controlled Trial.
Hornby, T George; Holleran, Carey L; Hennessy, Patrick W; Leddy, Abigail L; Connolly, Mark; Camardo, Jaclyn; Woodward, Jane; Mahtani, Gordhan; Lovell, Linda; Roth, Elliot J.
Afiliação
  • Hornby TG; University of Illinois at Chicago, Chicago, IL, USA Rehabilitation Institute of Chicago, Chicago, IL, USA Northwestern University, Chicago, IL, USA tgh@uic.edu.
  • Holleran CL; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Hennessy PW; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Leddy AL; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Connolly M; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Camardo J; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Woodward J; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Mahtani G; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Lovell L; Rehabilitation Institute of Chicago, Chicago, IL, USA.
  • Roth EJ; Rehabilitation Institute of Chicago, Chicago, IL, USA Northwestern University, Chicago, IL, USA.
Neurorehabil Neural Repair ; 30(5): 440-50, 2016 06.
Article em En | MEDLINE | ID: mdl-26338433
ABSTRACT

BACKGROUND:

Converging evidence suggests that the amount of stepping practice is an important training parameter that influences locomotor recovery poststroke. More recent data suggest that stepping intensity and variability are also important, although such strategies are often discouraged early poststroke.

OBJECTIVE:

The present study examined the efficacy of high-intensity, variable stepping training on walking and nonwalking outcomes in individuals 1 to 6 months poststroke as compared with conventional interventions. Methods Individuals with unilateral stroke (mean duration = 101 days) were randomized to receive ≤40, 1-hour experimental or control training sessions over 10 weeks. Experimental interventions consisted only of stepping practice at high cardiovascular intensity (70%-80% heart rate reserve) in variable contexts (tasks or environments). Control interventions were determined by clinical physical therapists and supplemented using standardized conventional strategies. Blinded assessments were obtained at baseline, midtraining, and posttraining with a 2-month follow-up. Results A total of 32 individuals (15 experimental) received different training paradigms that varied in the amount, intensity, and types of tasks performed. Primary outcomes of walking speed (experimental, 0.27 ± 0.22 m/s vs control, 0.09 ± 0.09 m/s) and distances (119 ± 113 m vs 30 ± 32 m) were different between groups, with stepping amount and intensity related to these differences. Gains in temporal gait symmetry and self-reported participation scores were greater following experimental training, without differences in balance or sit-to-stand performance. Conclusion Variable intensive stepping training resulted in greater improvements in walking ability than conventional interventions early poststroke. Future studies should evaluate the relative contributions of these training parameters.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Caminhada / Acidente Vascular Cerebral / Intenção / Terapia por Exercício / Reabilitação do Acidente Vascular Cerebral Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Caminhada / Acidente Vascular Cerebral / Intenção / Terapia por Exercício / Reabilitação do Acidente Vascular Cerebral Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article