Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study

Jacqueline C Outermans; Roland P S van Peppen; Harriet Wittink; Tim Takken; Gert Kwakkel

doi:10.1177/0269215509360647

Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study

Jacqueline C Outermans, Roland P S van Peppen, Harriet Wittink, Tim Takken, Gert Kwakkel

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

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

MEASURES: 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).

CONCLUSION: 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.

Original language	English
Pages (from-to)	979-87
Number of pages	9
Journal	Clinical Rehabilitation
Volume	24
Issue number	11
DOIs	https://doi.org/10.1177/0269215509360647
Publication status	Published - Nov 2010

Keywords

Cardiovascular Physiological Processes
Energy Metabolism
Exercise Therapy
Exercise Tolerance
Feasibility Studies
Female
Gait
Germany
Humans
Male
Middle Aged
Physical Therapy Modalities
Pilot Projects
Postural Balance
Respiratory Physiological Processes
Statistics, Nonparametric
Stroke
Walking

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title = "Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study",

abstract = "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.DESIGN AND SUBJECTS: Randomized controlled clinical trial: Forty-four patients with stroke were recruited at 2 to 8 weeks after stroke onset.MEASURES: 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).CONCLUSION: 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.",

keywords = "Cardiovascular Physiological Processes, Energy Metabolism, Exercise Therapy, Exercise Tolerance, Feasibility Studies, Female, Gait, Germany, Humans, Male, Middle Aged, Physical Therapy Modalities, Pilot Projects, Postural Balance, Respiratory Physiological Processes, Statistics, Nonparametric, Stroke, Walking",

author = "Outermans, {Jacqueline C} and {van Peppen}, {Roland P S} and Harriet Wittink and Tim Takken and Gert Kwakkel",

year = "2010",

month = nov,

doi = "10.1177/0269215509360647",

language = "English",

volume = "24",

pages = "979--87",

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T1 - Effects of a high-intensity task-oriented training on gait performance early after stroke

T2 - a pilot study

AU - Outermans, Jacqueline C

AU - van Peppen, Roland P S

AU - Wittink, Harriet

AU - Takken, Tim

AU - Kwakkel, Gert

PY - 2010/11

Y1 - 2010/11

N2 - 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.DESIGN AND SUBJECTS: Randomized controlled clinical trial: Forty-four patients with stroke were recruited at 2 to 8 weeks after stroke onset.MEASURES: 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).CONCLUSION: 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.

AB - 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.DESIGN AND SUBJECTS: Randomized controlled clinical trial: Forty-four patients with stroke were recruited at 2 to 8 weeks after stroke onset.MEASURES: 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).CONCLUSION: 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.

KW - Cardiovascular Physiological Processes

KW - Energy Metabolism

KW - Exercise Therapy

KW - Exercise Tolerance

KW - Feasibility Studies

KW - Female

KW - Gait

KW - Germany

KW - Humans

KW - Male

KW - Middle Aged

KW - Physical Therapy Modalities

KW - Pilot Projects

KW - Postural Balance

KW - Respiratory Physiological Processes

KW - Statistics, Nonparametric

KW - Stroke

KW - Walking

U2 - 10.1177/0269215509360647

DO - 10.1177/0269215509360647

M3 - Article

C2 - 20719820

SN - 0269-2155

VL - 24

SP - 979

EP - 987

JO - Clinical Rehabilitation

JF - Clinical Rehabilitation

IS - 11

ER -

Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study

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