The combined effect of task-oriented treadmill and high-intensity interval training on balance, gait parameters, and ADL in patients with chronic stroke: A randomized controlled trial with short-term follow-up

Background:This study aimed to determine the effect of task-oriented treadmill training with high-intensity interval training compared to high-intensity interval treadmill training on the walking ability of patients with chronic stroke.Methods:Data from 34 chronic stroke patients who were randomly assigned to experimental (17) and control (17) groups and completed the study were analyzed. The experimental group underwent task-oriented treadmill training with high-intensity interval training, and the control group received high-intensity interval treadmill training for 30 minutes per session, 3 times a week, over a period of 4 weeks. Statistical significance was confirmed through a 2-factor repeated measures analysis of variance.Results:There was an interaction effect between time and group for 10-Meter Walk test (10MWT), functional gait assessment (FGA), 6-Minute Walk test (6MWT), and timed up and go (TUG) (P < .05). post hoc tests revealed that 10MWT, FGA, and 6MWT showed significantly greater improvements in the e.g. compared to the CG (P < .025), and in the intragroup comparison, both e.g. and CG showed significant improvements over time (P < .017). The TUG showed no significant difference in comparison between groups (P > .025), and in comparison within groups, both e.g. and CG showed a significant decrease over time (P < .017).Conclusion:Clinically, despite being a chronic stroke patient, repetitive and meaningful task training combined with high-intensity training is thought to be helpful in improving walking ability and returning to the community.

The aim of this study was to evaluate the effect of anodal transcranial direct current stimulation over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living in patients with subacute stroke. This study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed. Although there was no clear significant difference between the two groups, when the changes from baseline to posttreatment evaluation were compared between the groups, a partially significant improvement was observed in the anodal stimulation group compared with the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in activities of daily living function was observed in the anodal stimulation group too. Anodal transcranial direct current stimulation over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and activities of daily living function in patients with sensory deficits after stroke.

Introduction:Gait characteristics are closely associated with executive functions including basic and high-level cognitive processes such as attention, working memory, decision-making, and problem-solving. Impaired cognitive function resulting from dementia is associated with loss of balance and poor activities of daily living (ADLs). If associations between gait parameters, balance, and ADLs are observed, then quantitative gait analysis may be optimal for reinforcing balance and ADL assessments in people with dementia. This study aimed to determine the association between balance, gait, and ADLs in older adults with dementia.Materials and Methods:A cross-sectional study was conducted in 46 older adults who have been diagnosed with dementia. Measurements including the Mini-Mental Statement Examination-Korean version (MMSE-K), Berg Balance Scale (BBS), 10-meter walk test (10MWT), Modified Barthel index (MBI), and GAITRite were used to assess cognitive function, balance, walking speed, ADLs, and gait parameters, respectively. The Pearson product correlation coefficient (r) was used for correlation analysis.Results and Discussion:Among the gait parameters, velocity was positively associated with the BBS, 10MWT, and MBI (r = 0.341-0.516, P > .05). Step length (r = 0.301-0.586, P > .05), stride length (r = 0.329-0.580, P > .05), and walk ratio (r = 0.324-0.556, P > .05) were positively associated with the MMSE-K, BBS, 10MWT, and MBI. A moderate positive association between single support time and MBI was observed (r = 0.308, P = .039). Additionally, a moderate negative association between double support time and the MBI was observed (r = −0.349, P = .019). This study presents the first empirical evidence on the association between balance, gait, and ADLs in older adults with dementia.Conclusions:This study identified important associations between balance, gait, and ADL assessments in people with dementia. Further studies involving targeted interventions addressing gait parameters and improving balance and functional performance in people with dementia are required in the future.

Many stroke patients show reduced walking abilities, characterized by asymmetric walking patterns. For such patients, restoration of walking symmetry is important. This study investigates the effect of treadmill training with visual feedback and rhythmic auditory cue (VF+RAC) for walking symmetry on spatiotemporal gait parameters and balance abilities. Thirty-two patients with chronic stroke participated in this study. Participants were randomized to either the VF+RAC (n = 16) or the Control (n = 16) group. The VF+RAC group received treadmill training with VF and RAC, and the Control group underwent treadmill training without any visual and auditory stimulation. VF+RAC and Control groups were trained three times per week for eight weeks. After eight weeks of training, the spatiotemporal gait parameters, Timed up and go test, and Berg balance scale were measured. The VF+RAC group significantly improved balance and spatiotemporal parameters except for non-paretic single limb support compared to the Control group. This study demonstrated that treadmill training with VF+RAC significantly improved spatiotemporal gait symmetry, including other gait parameters, and enhanced balance abilities in stroke patients. Therefore, treadmill training with VF+RAC could be a beneficial intervention in clinical settings for stroke patients who need improvement in their gait and balance abilities.

Chronic stroke can impair cardiopulmonary function, mobility, and daily activities. This study assessed the impact of robot-assisted gait training (RAGT) on such impairments. To investigate the effects of robot-assisted gait training on cardiopulmonary function, walking ability, lower extremity function and strength, activities of daily living (ADLs), and blood test results among individuals with chronic stroke. A multicenter, prospective, single-blinded, randomized controlled trial with 22 chronic stroke participants compared RAGT against a control exercise regimen. RAGT involved three days weekly sessions of high-intensity interval training for 8 weeks (24 sessions) with a Morning Walk® device. The control group also performed home exercises. (24 sessions) Measures included VO2max, Functional Ambulatory Category, 2-minute walk test, 10-meter walk test, Motricity Index-Lower, Korean version of the Fugl-Meyer Assessment Scale, Modified Barthel Index, Berg Balance Scale, muscle strength, InBody body composition, and blood tests (cholesterol, lipid, glucose). RAGT significantly improved VO2max, gait, balance, and lower limb strength compared with controls, with significant improvements in 2-minute walk test, 10-meter walk test, Motricity Index-Lower, and Fugl-Meyer Assessment outcomes. No changes were seen in muscle mass or blood markers. RAGT enhances cardiopulmonary function and ambulatory capacity in chronic stroke patients, underscoring its potential in stroke rehabilitation.

ObjectiveStroke is a leading cause of long-term disability, significantly impacting patients’ mobility and quality of life. Robot-assisted gait therapy (RAGT) and high-intensity interval training (HIIT) have individually shown potential in improving gait function in chronic stroke patients. This study investigated the potential effectiveness of combining high-intensity interval training (HIIT) with robot-assisted gait therapy (RAGT) to enhance gait, balance, and lower limb function in patients with chronic stroke.MethodsA randomized controlled trial was conducted with 48 patients with chronic stroke, of whom 44 patients (91.7%) completed the study. Participants were randomly assigned to a control group (treadmill-based gait therapy) or an intervention group (RAGT with HIIT using an end-effector robot). Both groups trained for 30 min, three times weekly, over 8 weeks. HIIT alternated between moderate and high intensities. Outcomes included the 10-meter walk test (10MWT), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Fugl-Meyer Assessment– Lower Extremity (FMA-LE), VO₂max, Modified Barthel Index (MBI), and lean body mass.ResultsBetween-group comparisons showed significant improvements in the intervention group in 10MWT (p < 0.001, d = 1.2), FAC (p = 0.009), BBS (p = 0.015), 2MWT (p = 0.005), and FMA-LE (p < 0.001) scores. Additionally, the intervention group demonstrated enhanced 2MWT (p < 0.001) and VO₂max (p = 0.005) within group; however, lean body mass within-group changes were minor in both groups. The superior outcomes in the intervention group highlight the potential combined benefits of combining HIIT with RAGT for intensive, repetitive, and task-specific training.ConclusionHIIT integrated with RAGT may be an effective approach for improving the gait and functional outcomes of patients with chronic stroke. This novel combination shows promise for enhancing rehabilitation strategies, with potential implications for optimizing functional recovery and quality of life.Trial registrationThe study was registered with the Clinical Research Information Service (KCT0007659).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12984-025-01674-0.

Efficacy of lateral stair walking training in patients with chronic stroke: A pilot randomized controlled study.

Six-Week Nordic Treadmill Training Compared with Treadmill Training on Balance, Gait, and Activities of Daily Living for Stroke Patients: A Randomized Controlled Trial

Objective: The purpose of this study was to investigate the effect of visual block with ankle joint fatigue on gait and dynamic balance ability. Design: Cross-sectional study. Methods: Thirty healthy young adults (men=15, women=15) between 22 to 25 years of age voluntarily participated in this study. All subjects performed the gait and dynamic balance test successively in two conditions: the visual block and the open eyes condition. Before the gait and dynamic balance test, muscle fatigue on the ankle joint was induced to all subjects by doing ankle dorsiflexion and plantarflexion alternately, and then gait parameters (step length, stride length, cadence, velocity, single limb support, and double limb support) were assessed by walking on the GAITRite system (CIR Systems Inc., USA). Subjects also performed the functional reach test (FRT) for assessment of dynamic balance. This study examined gait parameters and FRT scores in each visual block and open eyes condition. Results: The results showed that FRT scores with the visual block condition significantly decreased compared to without visual blocking (p<0.01). Step length, stride length, cadence, and velocity of gait parameters decreased significantly in the visual block condition (p<0.01) while there was no significant difference for single limb support. However, double limb support increased significantly in the visual block system (p<0.01). Conclusions: Therefore, blocking of visual information with muscle fatigue of the ankle joint can affect gait and balance ability of young adults and increase the risk of falls.

Outcome measures are designed to identify functional mobility issues, safety concerns, and areas for intervention. While gait and balance are often evaluated separately, they interact significantly. Understanding how various outcome measures relate to gait performance may allow for more targeted interventions. The purpose of this study was to examine the relationship between dynamic balance, as assessed by the instrumented Four Square Step Test (i-FSST), and gait parameters among community-dwelling adults and individuals with neurological conditions (stroke, multiple sclerosis [MS], or Parkinson's disease [PD]). This cross-sectional study used the i-FSST to assess dynamic balance in 40 individuals typical of a neurologic clinic (11 community dwelling adults, 10 individuals with Parkinson's disease, 10 with multiple sclerosis, and 9 individuals post stroke). Outcome measures included FSST duration, stepping patterns, quadrant transition timing, and time spent in the quadrants. Gait was assessed using temporal-spatial parameters (gait velocity, step length, gait variability index [GVI], double limb support [DLS], single limb support [SLS]). The i-FSST duration had a significant negative relationship with gait velocity (r=-0.754) and step length (r=-0.651). Additionally, i-FSST duration had a significant relationship with single limb support (SLS) (r=-0.593), double limb support (DLS) (r=0.588) and gait variability index (GVI) (r=0.594). ODS (defined as the number of double support periods) had a relationship with gait velocity (r=-0.559), step length (r=-0.562), GVI (r=0.573), SLS (r=-0.538), DLS (r=0.539). CMS (indicates number of times weight is transfers between legs) correlated with gait speed (r=-0.656), step length (r=-0.663), and GVI (r=0.515). The i-FSST demonstrates multiple significant associations with key gait metrics, suggesting its clinical utility in assessing balance-related factors that affect gait. Clinically, the test may aid in identifying impairments in weight shifting, directional movement, and dynamic balance.

Strength-Endurance Training Classes: Health Benefits and Injury Rates of an Emerging Cornerstone of Physical Activity

BackgroundStroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels. The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training (WBV-TT) on walking performance in patients with chronic stroke.Material/MethodsThirty ambulatory chronic stroke patients were randomly allocated to the WBV-TT group or the treadmill training (TT) group. The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4.5 minutes and then walked on the treadmill for 20 minutes. The participants in the TT group conducted the same exercise on a platform without vibration and then walked on the treadmill in the same manner. The vibration lasted for 45 seconds in each exercise, and the intervention was performed 3 times weekly for 6 weeks. The treadmill walking speed was gradually increased by 5% in both groups. The outcome measures included the temporospatial parameter of gait (GAITRite®) and 6-minute walk test.ResultsThe WBV-TT group showed significant improvements in walking performance with respect to walking speed, cadence, step length, stride length, single-limb support, double-limb support, and 6-minute walk test compared with baseline (p<0.05). Significant improvements were also seen in walking speed, step length, stride length, and double-limb support compared with the TT group (p<0.05).ConclusionsThese findings indicate that WBV-TT is more effective than TT for improving walking performance of patients with chronic stroke.

BackgroundVolleyball requires repeated explosive actions, agility, and technical precision, demanding contributions from both aerobic and anaerobic energy systems. Time-efficient training methods such as resistance-based high intensity interval training (HIIT) and high intensity functional training (HIFT) have been proposed to enhance multidimensional performance in young athletes. However, direct comparisons of their effects in adolescent female volleyball players are limited.MethodsThirty-two licensed female volleyball players (aged 15–18 years) were randomly assigned to a resistance-based HIIT group (n = 10), a HIFT group (n = 11), or a control group (n = 11). The training interventions lasted 12 weeks with two supervised sessions per week, in addition to regular volleyball practice. The HIIT program consisted of progressive resistance-based high intensity intervals performed at 85–95% HRmax, while the HIFT program comprised multimodal circuit-style functional exercises performed at comparable intensities (~ 85–95% HRmax). Performance assessments were conducted pre- and post-intervention and included the countermovement jump (CMJ), standing long jump (SLJ), medicine ball throw (MBT), pro-agility test, 20 m sprint, repeated sprint fatigue index (RSI), volleyball skill test, Yo-Yo IR1 distance, VO₂max, blood lactate concentration, and maximal heart rate (MaxHR). Data were analyzed using a 3 × 2 mixed-model ANOVA with Tukey post hoc tests, and effect sizes were reported as Cohen’s d and partial eta squared (ηp²).ResultsSignificant Group × Time interactions were observed for CMJ (F(2,29) = 9.14, p < 0.001, ηp²=0.39), SLJ (F(2,29) = 12.08, p < 0.001, ηp²=0.45), VO₂max (F(2,29) = 11.53, p < 0.001, ηp²=0.44), MaxHR (F(2,29) = 3.56, p = 0.041, ηp²=0.20), and volleyball skill test (F(2,29) = 7.44, p = 0.002, ηp²=0.34). HIFT produced the greatest improvements in explosive power (CMJ Δ=+5.15 cm; SLJ Δ=+12.82 cm), RSI (Δ=–1.56), and volleyball skill performance (Δ=+13.18 points), with large effect sizes (d = 1.3–3.2). HIIT showed relatively greater improvements in aerobic capacity (VO₂max Δ=+0.90 ml·kg⁻¹·min⁻¹) and endurance (d = 0.7–2.0). No significant between-group differences were observed for lactate.ConclusionsBoth resistance-based HIIT and HIFT proved effective in improving several physical and volleyball-specific performance components in adolescent female players. HIIT produced slightly greater gains in aerobic capacity, while HIFT showed larger numerical improvements in explosive strength, agility, and technical skill performance; however, these between-intervention differences were not statistically significant. Overall, the findings suggest that each modality offers complementary benefits, and integrating both HIIT and HIFT may provide a balanced conditioning approach for the holistic development of youth volleyball athletes.Trial registrationClinicalTrials.gov Identifier: NCT07181031. Registered on September 04, 2025.

This study examined sex-specific responses during self-paced, high-intensity interval training (HIIT). Sixteen (8 men and 8 women) individuals completed a peak oxygen uptake test and 3 treadmill HIIT sessions on separate days. The HIIT sessions consisted of six 4-minute intervals performed at the highest self-selected intensity individuals felt they could maintain. Recovery between intervals was counterbalanced and consisted of 1-, 2-, or 4-minute recovery during each trial. Relative measures of intensity, including percentage of velocity at VO2peak (vVO2peak), %VO2peak, %HRmax, and blood lactate concentration ([La]), were observed during the trials. Perceived readiness was recorded immediately before and ratings of perceived exertion (RPE) were recorded at the end of each interval with session RPE recorded after each trial. Results revealed a significant effect of sex on %vVO2peak (p < 0.01) and %HRmax (p < 0.01). Data show that across trials, men self-select higher %vVO2peak (84.5 vs. 80.7%), whereas women produce higher %HRmax (96.9 vs. 92.1%) and %VO2peak (89.6 vs. 86.1%) with no difference in [La] or perceptual responses. These findings support the notion that women may demonstrate improved recovery during high-intensity exercise, as they will self-select intensities resulting in greater cardiovascular strain. Moreover, results confirm previous findings suggesting that a 2:1 work-to-rest ratio is optimal during HIIT for both men and women.

Objective: The arm swing is associated with gait ability in healthy young adults. The purpose of this study was to examine the effects of arm swing during gait in healthy young adults. Design: Cross-sectional study. Methods: Forty-five subjects without any orthopedic or neurological injuries participated in this study. All subjects performed all three conditions according to the arm swing type as follows: first procedure (condition 1), walking as usual without arm swing constraint; second procedure (condition 2), constraint of dominant arm swing walking as usual; third procedure (condition 3), constraint of both arm swing walking as usual. Gait parameters such as gait velocity, stride length, cadence, step time, single limb support, and double limb support were measured in all arm swing conditions performed randomly, with the mean value obtained from three measurements. A rest period of 5 minutes was given to prevent repetition of each condition and learning effect. All data was analyzed using repeated measures ANOVA to notice the changes between arm swing conditions. Results: Within walking conditions, significant difference of gait velocity, stride length, cadence, and double limb support was noticed (p<0.05), except step time and single limb support. Gait velocity and stride length were significant reduced, and in cadence and double limb support were increased (p<0.05). Condition 3 had the most significant decrease of gait ability compared with condition 1 (p<0.05). Conclusions: These finding suggested that constraint arm swing conditions reduced gait ability in healthy young adults. Also, these findings can be utilized as a reference to future studies that not only pelvic, knee and ankle, but also upper limb affect to gait ability.