Effect of intensive outpatient physical training on gait performance and cardiovascular health in people with hemiparesis after stroke.

BACKGROUND Stroke can result in severe motor deficits, and many people who have survived a stroke have poor cardiovascular fitness, with potentially disabling effects on daily life. OBJECTIVE The objective of this study was to evaluate the impact of intensive physical training on gait performance and cardiovascular health parameters in people with stroke in the chronic stage. DESIGN This was a single-group, pretest-posttest experimental study. METHODS Fourteen people with hemiparesis after cerebrovascular injury (mean age=58.4 years, mean time since injury=25 months) participated in a 12-week training intervention, 5 times per week for 1.5 hours per session. The intervention consisted of high-intensity, body-weight-supported treadmill training; progressive resistance strength training; and aerobic exercise. The main outcome measures were gait performance (Six-Minute Walk Test, 10-Meter Walk Test, and aerobic capacity) and parameters of cardiovascular health (systolic and diastolic blood pressures, body mass index, and resting heart rate). RESULTS Significant improvements in all main outcome parameters were observed in response to the intervention. Gait speed during the Six-Minute Walk Test increased 62%, and systolic and diastolic blood pressures decreased 10% and 11%, respectively. Weekly testing of walking speed showed that most of the increase in the walking speed occurred in the first 8 weeks of training. Correlation analyses showed that improvements were unrelated to age, chronicity, or level of functioning. CONCLUSIONS High-intensity physical training for people with stroke in the chronic stage increased walking speed regardless of chronicity, age, or level of functioning. Further studies should investigate the intervention duration needed to reach the full potential of gait recovery.