The Value of High Intensity Locomotor Training Applied to Patients With Acute-Onset Neurologic Injury

Arch Phys Med Rehabil, 2022 · DOI: 10.1016/j.apmr.2020.09.399 · Published: July 1, 2022

Simple Explanation

This review discusses how exercise intensity affects locomotor training in stroke and iSCI patients, defining intensity, exertion methods, and safety concerns. Exercise intensity is the rate of work or power output, increased by faster walking or added loads, often measured by heart rate. High-intensity training shows promise for improving walking function after neurologic injury, but implementation faces challenges like equipment costs and safety concerns.

Study Duration

Not specified

Participants

Patients with stroke and incomplete spinal cord injury (iSCI)

Evidence Level

Review

Key Findings

1
Exercise training intensity is likely a major factor influencing locomotor function after neurologic injury, supported by multiple studies and meta-analyses.
2
High-intensity training can lead to improvements in timed walking distance, VO2peak, and gait efficiency in stroke patients.
3
Gains in walking function are more significant with high-intensity training when combined with tasks specific to community mobility demands.

Research Summary

This review examines the effects of exercise intensity during locomotor training in patients with stroke and iSCI, emphasizing the importance of cardiovascular exertion. High-intensity training shows promise for improving locomotor function, with benefits observed in timed walking distance, VO2peak, and gait efficiency. Implementation of high-intensity training in clinical settings requires addressing equipment costs, personnel availability, and appropriate measures of training intensity.

Practical Implications

Clinical Practice

Therapists should consider incorporating high-intensity locomotor training into rehabilitation programs for stroke and iSCI patients to improve walking function.

Research

Further research is needed to optimize the implementation of high-intensity training in clinical settings, including addressing equipment costs, personnel availability, and safety concerns.

Patient Care

Patients with neurologic injury may benefit from high-intensity training, but it's crucial to monitor cardiovascular responses and adjust exercise intensity accordingly.

Study Limitations

1
Limited data on the potential associations between biomechanical gait abnormalities and orthopedic injuries related to high-intensity training.
2
Inconsistent effect of high intensity training on comfortable walking speed and community mobility in both stroke and SCI.
3
Concerns regarding safety and feasibility commonly arise during attempted clinical implementation.

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