Using Outcome Measures to Promote Clinically Successful High Intensity Gait Training in Stroke Populations

Abstract

<h3>Research Objectives</h3> To investigate the use of outcome measures (OMs) to identify patients who are unlikely to succeed at over ground training (OGT) high intensity gait training (HIGT). <h3>Design</h3> Cross-over design, case series. <h3>Setting</h3> Outpatient PT. <h3>Participants</h3> 6 stroke patients with mean acuity of 3.1yrs. Average age of 46yrs and no medical contraindications to HIGT. <h3>Interventions</h3> Treadmill Training (TT) or OGT HIGT were performed 30 minutes/session for 2 sessions. Successful HIGT was defined as achieving a minimum of 60% heart rate reserve. <h3>Main Outcome Measures</h3> 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT) <h3>Results</h3> Successful OGT patients' mean 10MWT was 1.08m/s (self-paced) and 1.61m/s (fast-paced) with a mean 6MWT distance of 398.5m. Unsuccessful OGT HIGT patients' 10MWT was 0.75m/s (self-paced) and 0.87m/s (fast-paced) with a mean 6MWT distance of 242m. Unsuccessful OGT patient achieved 110% of their 60% HRR goal during TT as compared to just 84% of the same goal during OGT HIGT. In contrast, successful OGT patients achieved 114% of their goal during OGT and 111% of this goal during TT. <h3>Conclusions</h3> Clinically significant differences existed in scores on the 10MWT and 6MWT between patients who succeeded or failed at OGT HIGT. Unsuccessful OGT HIGT patients' self- and fast-paced gait speeds were respectively, 0.33m/s and 0.73m/s, slower than those achieved on average in the successful OGT group. 6MWT distance was a mean 156.5m less than the successful OGT HIGT group. Patients with a self-selected 10MWT 0.75m/s or 6MWT distance of 242m may be less likely to achieve successful OGT HIGT given this case series' results. These findings promote the clinical implementation of HIGT by preliminarily supporting the use of OMs to identify which patients should begin with TT versus OGT HIGT. <h3>Author(s) Disclosures</h3> Nothing to disclose.