Abigail L Leddy1, Mark Connolly, Carey L Holleran, Patrick W Hennessy, Jane Woodward, Ross A Arena, Elliot J Roth, T George Hornby. 1. Sensory Motor Performance Program (A.L.L., M.C., C.L.H., P.W.H., J.W., T.G.H.), Rehabilitation Institute of Chicago, Chicago, Illinois; Department of Physical Medicine and Rehabilitation (R.A.A., E.J.R., T.G.H.), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Physical Therapy and Kinesiology & Nutrition (R.A.A.), University of Illinois at Chicago; and Department of Physical Medicine and Rehabilitation (T.G.H.), Indiana University School of Medicine, Indianapolis, Indiana.
Abstract
BACKGROUND AND PURPOSE: Impairments in metabolic capacity and economy (O2cost) are hallmark characteristics of locomotor dysfunction following stroke. High-intensity (aerobic) training has been shown to improve peak oxygen consumption in this population, with fewer reports of changes in O2cost. However, particularly in persons with subacute stroke, inconsistent gains in walking function are observed with minimal associations with gains in metabolic parameters. The purpose of this study was to evaluate changes in aerobic exercise performance in participants with subacute stroke following high-intensity variable stepping training as compared with conventional therapy. METHODS: A secondary analysis was performed on data from a randomized controlled trial comparing high-intensity training with conventional interventions, and from the pilot study that formed the basis for the randomized controlled trial. Participants 1 to 6 months poststroke received 40 or fewer sessions of high-intensity variable stepping training (n = 21) or conventional interventions (n = 12). Assessments were performed at baseline (BSL), posttraining, and 2- to 3-month follow-up and included changes in submaximal (Equation is included in full-text article.)O2 ((Equation is included in full-text article.)O2submax) and O2cost at fastest possible treadmill speeds and peak speeds at BSL testing. RESULTS: Significant improvements were observed in (Equation is included in full-text article.)O2submax with less consistent improvements in O2cost, although individual responses varied substantially. Combined changes in both (Equation is included in full-text article.)O2submax and (Equation is included in full-text article.)O2 at matched peak BSL speeds revealed stronger correlations to improvements in walking function as compared with either measure alone. DISCUSSION AND CONCLUSIONS:High-intensity stepping training may elicit significant improvements in (Equation is included in full-text article.)O2submax, whereas changes in both peak capacity and economy better reflect gains in walking function. Providing high-intensity training to improve locomotor and aerobic exercise performance may increase the efficiency of rehabilitation sessions.Video Abstract available for more insights from the authors (see Supplemental Digital Content, http://links.lww.com/JNPT/A142).
RCT Entities:
BACKGROUND AND PURPOSE: Impairments in metabolic capacity and economy (O2cost) are hallmark characteristics of locomotor dysfunction following stroke. High-intensity (aerobic) training has been shown to improve peak oxygen consumption in this population, with fewer reports of changes in O2cost. However, particularly in persons with subacute stroke, inconsistent gains in walking function are observed with minimal associations with gains in metabolic parameters. The purpose of this study was to evaluate changes in aerobic exercise performance in participants with subacute stroke following high-intensity variable stepping training as compared with conventional therapy. METHODS: A secondary analysis was performed on data from a randomized controlled trial comparing high-intensity training with conventional interventions, and from the pilot study that formed the basis for the randomized controlled trial. Participants 1 to 6 months poststroke received 40 or fewer sessions of high-intensity variable stepping training (n = 21) or conventional interventions (n = 12). Assessments were performed at baseline (BSL), posttraining, and 2- to 3-month follow-up and included changes in submaximal (Equation is included in full-text article.)O2 ((Equation is included in full-text article.)O2submax) and O2cost at fastest possible treadmill speeds and peak speeds at BSL testing. RESULTS: Significant improvements were observed in (Equation is included in full-text article.)O2submax with less consistent improvements in O2cost, although individual responses varied substantially. Combined changes in both (Equation is included in full-text article.)O2submax and (Equation is included in full-text article.)O2 at matched peak BSL speeds revealed stronger correlations to improvements in walking function as compared with either measure alone. DISCUSSION AND CONCLUSIONS: High-intensity stepping training may elicit significant improvements in (Equation is included in full-text article.)O2submax, whereas changes in both peak capacity and economy better reflect gains in walking function. Providing high-intensity training to improve locomotor and aerobic exercise performance may increase the efficiency of rehabilitation sessions.Video Abstract available for more insights from the authors (see Supplemental Digital Content, http://links.lww.com/JNPT/A142).
Authors: T George Hornby; Carey L Holleran; Patrick W Hennessy; Abigail L Leddy; Mark Connolly; Jaclyn Camardo; Jane Woodward; Gordhan Mahtani; Linda Lovell; Elliot J Roth Journal: Neurorehabil Neural Repair Date: 2015-09-03 Impact factor: 3.919
Authors: Pamela W Duncan; Katherine J Sullivan; Andrea L Behrman; Stanley P Azen; Samuel S Wu; Stephen E Nadeau; Bruce H Dobkin; Dorian K Rose; Julie K Tilson; Steven Cen; Sarah K Hayden Journal: N Engl J Med Date: 2011-05-26 Impact factor: 91.245
Authors: Steven A Kautz; Pamela W Duncan; Subashan Perera; Richard R Neptune; Stephanie A Studenski Journal: Neurorehabil Neural Repair Date: 2005-09 Impact factor: 3.919
Authors: Carey L Holleran; Don D Straube; Catherine R Kinnaird; Abigail L Leddy; T George Hornby Journal: Neurorehabil Neural Repair Date: 2014-02-10 Impact factor: 3.919
Authors: Louis N Awad; Jacqueline A Palmer; Ryan T Pohlig; Stuart A Binder-Macleod; Darcy S Reisman Journal: Neurorehabil Neural Repair Date: 2014-10-05 Impact factor: 3.919
Authors: Gabrielle Brazg; Meghan Fahey; Carey L Holleran; Mark Connolly; Jane Woodward; Patrick W Hennessy; Brian D Schmit; T George Hornby Journal: Neurorehabil Neural Repair Date: 2017-10-30 Impact factor: 3.919
Authors: Tanya Onushko; Gordhan B Mahtani; Gabrielle Brazg; T George Hornby; Brian D Schmit Journal: J Neurotrauma Date: 2019-03-28 Impact factor: 5.269
Authors: T George Hornby; Abbey Plawecki; Jennifer K Lotter; Molly E Scofield; Emily Lucas; Christopher E Henderson Journal: Phys Ther Date: 2022-08-04
Authors: Carey L Holleran; Patrick W Hennessey; Abigail L Leddy; Gordhan B Mahtani; Gabrielle Brazg; Brian D Schmit; T George Hornby Journal: J Neurol Phys Ther Date: 2018-04 Impact factor: 3.649
Authors: Carolina C Alcantara; Luisa F García-Salazar; Marcela A Silva-Couto; Gabriela L Santos; Darcy S Reisman; Thiago L Russo Journal: Front Neurol Date: 2018-08-28 Impact factor: 4.003