Partial Body Research Articles

Measurement of muscle mass in sarcopenia: from imaging to biochemical markers.

Sarcopenia encompasses the loss of muscle mass and strength/function during aging. Several methods are available for the estimation of muscle or lean body mass. Popular assessment tools include body imaging techniques (e.g., magnetic resonance imaging, computed tomography, dual X-ray absorptiometry, ultrasonography), bioelectric impedance analysis, anthropometric parameters (e.g., calf circumference, mid-arm muscle circumference), and biochemical markers (total or partial body potassium, serum and urinary creatinine, deuterated creatine dilution method). The heterogeneity of the populations to be evaluated as well as the setting in which sarcopenia is investigated impacts the definition of "gold standard" assessment techniques. The aim of this article is to critically review available methods for muscle mass estimation, highlighting strengths and weaknesses of each of them as well as their proposed field of application.

Topical Nanoemulgel: A Novel Pathway for Investigating Alopecia

Alopecia areata (hair loss) is an auatoimmune disease occurs in both sexes and is characterized by partial, complete and total body hair loss. The severity of the condition and the patient’s age are the tailored factors responsible for the hair loss. The FDA approved Minoxidil as a topical medication with proven efficacy for treating different types of alopecia’s. This review will discuss the effect of topical nanoemulgel over other formulations for the treatment of alopecia areata. The nanoemulgel will shows better solubility and permeability of the active components at the site of application via opening of hair follicles or other routes, as compared to other formulations.

Effect of treadmill training with partial body weight support on spine geometry and gross motor function in children with diplegic cerebral palsy

Abstract Back ground: Cerebral palsy children suffer from neuromuscular and musculoskeletal problems such as spasticity, muscle contractures, bony deformities, incoordination and muscle weakness that interfere with motor function. The aim of this study was to evaluate the effect of treadmill training with partial body weight support on spine geometry and gross motor function in spastic diplegic cerebral palsy children. Methods: 31 children with spastic diplegia (5-7 years) were recruited and randomly allocated to control group (15) and study group (16). Of these, 30 children completed training and testing. Both groups received a specially designed therapeutic exercise program. The study group additionally received treadmill training with partial body weight support (30% relief of total body weight). Treatment was provided 3d/w for 3 successive months. Assessment was performed before and after intervention. Trunk imbalance, pelvic tilt scores using formatric instrumentation system were recorded. Gross motor function (standing and walking) scores using gross motor function measurement scale were recorded. Results: children in both groups showed a significant improvements in the mean values of all measured variables post-treatment (p

Treadmill-Based Locomotor Training with Leg Weights in People with Chronic Stroke

BACKGROUND OF STUDY: Novel locomotor training strategies for individuals with disorders of the central nervous system have associated with the improved locomotor function. OBJECTIVES: The goal of this study was to find the effects of treadmill-based locomotor training with leg weights in individuals with chronic stroke. We assessed impairment and gait parameters in functional ambulation persons with chronic stroke. METHODS: We used a Pretest-posttest design. Twenty individuals with chronic stroke who were community ambulatory were recruited. Participants underwent 30-minute treadmill-based locomotor training sessions three times per week for four weeks. The training program involved treadmill walking for 30 minutes with partial body weight support as needed. Leg weights, equivalent to 5% of body weight affixed around the paretic leg. Gait parameters such as cadence, step length, and stride length and the Modified Emory Functional Ambulation Profile (mEFAP) as an outcome measures used. RESULTS: Improvements were more significant in cadence than other gait parameters such as step length and stride length. The more significant improvement was seen in step length than in stride length. In mEFAP, 5.98% improvement was seen showing enhanced the functional ambulatory capacity of participants. In Chedokemcmaster Stroke Assessment Activity Inventory, 4.27% improvement was seen. CONCLUSION: This study demonstrates that treadmill-based locomotor training combined with leg weights could be a feasible approach for improving the ability to perform complex walking tasks, such as stair climbing, in individuals with chronic stroke.

Two-Segment Foot Model for the Biomechanical Analysis of Squat.

Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot. The forefoot and hindfoot are articulated by the midtarsal joint. Five subjects performed a series of three trials, and results were averaged. Joint kinematics and dynamics were obtained using motion capture system, two force plates closed together, and inverse dynamics techniques. The midtarsal joint reached a dorsiflexion peak of 4°. Different strategies between subjects revealed 4° supination and 2.5° pronation of the forefoot. Vertical GRF showed 20% of body weight concentrated on the forefoot and 30% on the hindfoot. The percentages varied during motion, with a peak of 40% on the hindfoot and correspondently 10% on the forefoot, while the traditional model depicted the unique constant 50% value. Ankle peak of plantarflexion moment, power absorption, and power generation was consistent with values estimated by the one-segment model, without statistical significance.

Cardiometabolic risk improvement in response to a 3-yr lifestyle modification program in men: contribution of improved cardiorespiratory fitness vs. weight loss.

Our objective was to examine the respective contributions of changes in visceral adiposity, subcutaneous adiposity, liver fat, and cardiorespiratory fitness (CRF) to the improvements in cardiometabolic risk markers in response to a 3-yr healthy eating/physical activity lifestyle intervention. Ninety-four out of 144 viscerally obese healthy men completed a 3-yr lifestyle intervention. Body weight, body composition, and fat distribution were assessed by anthropometry and DEXA/computed tomography. CRF, adipokines, lipoprotein/lipid profile, and 75 g of oral glucose tolerance were assessed. CRF and visceral and subcutaneous adiposity significantly improved over the 3-yr intervention, with a nadir in year 1 and a partial regain in year 3 Liver fat (estimated by insulin hepatic extraction) stabilized from year 1 to year 3, whereas HOMA-IR, ISI-Matsuda index, and adiponectin continued to improve. Multivariate analysis revealed that both visceral adiposity and estimated liver fat reductions contributed to the improved ISI-Matsuda index observed over 3 yr (r2 = 0.28, P < 0.001). Three-year changes in fat mass and CRF were independently associated with changes in visceral fat (adjusted r2 = 0.40, P < 0.001), whereas only changes in CRF were associated with changes in estimated liver fat (adjusted r2 = 0.18, P < 0.001). A long-term (3 yr) healthy eating/physical activity intervention in men improves several cardiometabolic risk markers over the long term (3 yr) despite a partial body weight regain observed between year 1 and year 3 The improvement in CRF contributes to visceral and estimated liver fat losses over the long term, which in turn explain the benefits of the lifestyle intervention on cardiometabolic risk profile.

Automated Analysis of C. elegans Swim Behavior Using CeleST Software.

Dissecting the neuronal and neuromuscular circuits that regulate behavior remains a major challenge in biology. The nematode Caenorhabditis elegans has proven to be an invaluable model organism in helping to tackle this challenge, from inspiring technological approaches, building the human brain connectome, to actually shedding light on the specific molecular drivers of basic functional patterns. The bulk of the behavioral studies in C. elegans have been performed on solid substrates. In liquid, animals exhibit behavioral patterns that include movement at a range of speeds in 3D, as well as partial body movements, such as a posterior curl without anterior shape change, which introduce new challenges for quantitation. The steps of a simple procedure, and use of a software that enables high-resolution analysis of C. elegans swim behavior, are presented here. The software, named CeleST, uses a specialized computer program that tracks multiple animals simultaneously and provides novel measures of C. elegans locomotion in liquid (swimming). The measures are mostly grounded in animal posture and based on mathematics used in computer vision and pattern recognition, without computational requirements for threshold cut-offs. The software tool can be used to both assess overall swimming prowess in hundreds of animals from combined small batch trials and to reveal novel phenotypes even in well-characterized genetic mutants. The preparation of specimens for analysis with CeleST is simple and low-tech, enabling wide adaptation by the scientific community. Use of the computational approach described here should therefore contribute to the greater understanding of behavior and behavioral circuits in the C. elegans model.

Automated Analysis of &lt;em&gt;C. elegans&lt;/em&gt; Swim Behavior Using CeleST Software

Dissecting the neuronal and neuromuscular circuits that regulate behavior remains a major challenge in biology. The nematode Caenorhabditis elegans has proven to be an invaluable model organism in helping to tackle this challenge, from inspiring technological approaches, building the human brain connectome, to actually shedding light on the specific molecular drivers of basic functional patterns. The bulk of the behavioral studies in C. elegans have been performed on solid substrates. In liquid, animals exhibit behavioral patterns that include movement at a range of speeds in 3D, as well as partial body movements, such as a posterior curl without anterior shape change, which introduce new challenges for quantitation. The steps of a simple procedure, and use of a software that enables high-resolution analysis of C. elegans swim behavior, are presented here. The software, named CeleST, uses a specialized computer program that tracks multiple animals simultaneously and provides novel measures of C. elegans locomotion in liquid (swimming). The measures are mostly grounded in animal posture and based on mathematics used in computer vision and pattern recognition, without computational requirements for threshold cut-offs. The software tool can be used to both assess overall swimming prowess in hundreds of animals from combined small batch trials and to reveal novel phenotypes even in well-characterized genetic mutants. The preparation of specimens for analysis with CeleST is simple and low-tech, enabling wide adaptation by the scientific community. Use of the computational approach described here should therefore contribute to the greater understanding of behavior and behavioral circuits in the C. elegans model.

MicroRNA Expression for Early Prediction of Late Occurring Hematologic Acute Radiation Syndrome in Baboons.

For effective medical management of radiation-exposed persons after a radiological/nuclear event, blood-based screening measures in the first few days that could predict hematologic acute radiation syndrome (HARS) are needed. For HARS severity prediction, we used microRNA (miRNA) expression changes measured on days one and two after irradiation in a baboon model. Eighteen baboons underwent different patterns of partial or total body irradiation, corresponding to an equivalent dose of 2.5 or 5 Gy. According to changes in blood cell counts (BCC) the surviving baboons (n = 17) exhibited mild (H1-2, n = 4) or more severe (H2-3, n = 13) HARS. In a two Stage study design we screened 667 miRNAs using a quantitative real-time polymerase chain reaction (qRT-PCR) platform. In Stage II we validated candidates where miRNAs had to show a similar regulation (up- or down-regulated) and a significant 2-fold miRNA expression difference over H0. Seventy-two candidate miRNAs (42 for H1-2 and 30 for H2-3) were forwarded for validation. Forty-two of the H1-2 miRNA candidates from the screening phase entered the validation step and 20 of them showed a statistically significant 2–4 fold up-regulation relative to the unexposed reference (H0). Fifteen of the 30 H2-3 miRNAs were validated in Stage II. All miRNAs appeared 2–3 fold down-regulated over H0 and allowed an almost complete separation of HARS categories; the strongest candidate, miR-342-3p, showed a sustained and 10-fold down-regulation on both days 1 and 2. In summary, our data support the medical decision making of the HARS even within the first two days after exposure where diagnostic tools for early medical decision are required but so far missing. The miRNA species identified and in particular miR-342-3p add to the previously identified mRNAs and complete the portfolio of identified mRNA and miRNA transcripts for HARS prediction and medical management.

Metabolic surgery with Roux-en-y Gastric bypass is an effective treatment in patients with Familial Partial Lipodystrophy and Body Mass Index Less than 35 kg/m2

Metabolic surgery with Roux-en-y Gastric bypass is an effective treatment in patients with Familial Partial Lipodystrophy and Body Mass Index Less than 35 kg/m2

Non-targeted transcriptomic effects upon thyroid irradiation: similarity between in-field and out-of-field responses varies with tissue type.

Non-targeted effects can induce responses in tissues that have not been exposed to ionizing radiation. Despite their relevance for risk assessment, few studies have investigated these effects in vivo. In particular, these effects have not been studied in context with thyroid exposure, which can occur e.g. during irradiation of head and neck tumors. To determine the similarity between in-field and out-of-field responses in normal tissue, we used a partial body irradiation setup with female mice where the thyroid region, the thorax and abdomen, or all three regions were irradiated. After 24 h, transcriptional regulation in the kidney cortex, kidney medulla, liver, lungs, spleen, and thyroid was analyzed using microarray technology. Thyroid irradiation resulted in transcriptional regulation in the kidney medulla and liver that resembled regulation upon direct exposure of these tissues regarding both strength of response and associated biological function. The kidney cortex showed fewer similarities between the setups, while the lungs and spleen showed little similarity between in-field and out-of-field responses. Interestingly, effects were generally not found to be additive. Future studies are needed to identify the molecular mechanisms that mediate these systemic effects, so that they may be used as targets to minimize detrimental side effects in radiotherapy.

A Randomized Comparison of Locomotor Therapy Interventions: Partial Body Weight Supported Treadmill, Lokomat® and G-Eo® Training in Traumatic Brain Injury

A Randomized Comparison of Locomotor Therapy Interventions: Partial Body Weight Supported Treadmill, Lokomat® and G-Eo® Training in Traumatic Brain Injury

THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte). Methods: We evaluated thirteen patients (14 hernias) treated by the posterior approach. Eight (61.5%) patients were male and the mean age was 53 years (34-81). Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months). Of the 14 operated hernias, six (43%) were lateral, 2 (14%) paramedian, and 6 (43%) central. Seven were soft (50%) and seven were calcified. The transfacet approach was carried out in 5 cases (36%), transpedicular in 1 case (7%), transpedicular + partial body resection in 4 (29%), costotransversectomy in 3 (21%), and costotransversectomy + CAGE in one case (7%). The majority of patients with lateral hernia (5/6) were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.

Novel technique for high-precision stereotactic irradiation of mouse brains.

Small animal irradiation systems were developed for preclinical evaluation of tumor therapy closely resembling the clinical situation. Mostly only clinical LINACs are available, so protocols for small animal partial body irradiation using aconventional clinical system are essential. This study defines aprotocol for conformal brain tumor irradiations in mice. CT and MRI images were used to demarcate the target volume and organs at risk. Three 6MV photon beams were planned for atotal dose of 10fractions of 1.8Gy. The mouse position in adedicated applicator was verified by an X‑ray patient positioning system before each irradiation. Dosimetric verifications (using ionization chambers and films) were performed. Irradiation-induced DNA damage was analyzed to verify the treatment effects on the cellular level. The defined treatment protocol and the applied fractionation scheme were feasible. The in-house developed applicator was suitable for individual positioning at submillimeter accuracy of anesthetized mice during irradiation, altogether performed in less than 10min. All mice tolerated the treatment well. Measured dose values perfectly matched the nominal values from treatment planning. Cellular response was restricted to the target volume. Clinical LINAC-based irradiations of mice offer the potential to treat orthotopic tumors conformably. Especially with respect to lateral penumbra, dedicated small animal irradiation systems exceed the clinical LINAC solution.

Operator dermal exposure and protection provided by personal protective equipment and working coveralls during mixing/loading, application and sprayer cleaning in vineyards

The efficiency of a working coverall combined with personal protective equipment to protect operators against dermal exposure to plant protection products under field conditions was studied. Operators wore a non-certified water-repellent finish polyester/cotton coverall plus a certified gown during the mixing/loading and the cleaning phases. Insecticide foliar application to a vineyard was selected as the exposure scenario. The overall dermal residue levels measured in this study were in the range of data recently collected in Europe. The water-repellent finish working coverall reduced body exposure by a factor of approximately 95%. Wearing a Category III Type 3 partial body gown during mixing/loading and cleaning of the application equipment led to a further protective effect of 98.7%. The combination of a water-repellent finish working coverall and partial body protection during specific tasks provided satisfactory levels of protection and can be considered as suitable protection for the conditions of use studied.

Automatic recognition of anatomical regions in three-dimensional medical images

This paper presents a method that detects anatomy regions in three-dimensional medical images. The method labels each axial slice of the image according to the anatomy region it belongs to. The detected regions are the head (and neck), the chest, the abdomen, the pelvis, and the legs. The proposed method consists of two main parts. The core of the algorithm is based on a two-dimensional feature extraction that is followed by a random forest classification. This recognition process achieves an overall accuracy of 91.5% in slice classification, but it cannot always provide fully consistent labeling. The subsequent post-processing step incorporates the expected sequence and size of the human anatomy regions in order to improve the accuracy of the labeling. In this part of the algorithm the detected anatomy regions (represented by Gaussian distributions) are fitted to the region probabilities provided by the random forest classifier. The proposed method was evaluated on a set of whole-body MR images. The results demonstrate that the accuracy of the labeling can be increased to 94.1% using the presented post-processing. In order to demonstrate the robustness of the proposed method it was applied to partial MRI scans of different sizes (cut from the whole-body examinations). According to the results the proposed method works reliably (91.3%) for partial body scans (having as little length as 35cm) as well.

A clinical case study of long-term injury of the thoracic and lumbar spine

Overestimation of the efficacy of conservative treatment of spine injuries children often leads to unsatisfactory long-term results. The effective correction of post-traumatic spinal column deformities occurs in patients who undergo the operation in the early post-traumatic period. While choosing treatment strategies for children, higher reparative opportunities, which provide early fracture consolidation, including those in faulty positions, should be considered. This study presents a case of surgical treatment for uncomplicated injury of the thoracic and lumbar spine, with long-term compression fragmental fracture of the L1 vertebra body in a 12-year-old child. Due to the long-standing character of the injury right thoraco-frenotomy was conducted with partial L1 vertebral body and resection of the adjacent discs, deformity correction of the thoracic and lumbar spine with a transpedicular system, and ventral spondylodesis with an autograft. This extensive intervention was justified by the peculiarities in the vertebral body damage and the post-traumatic segmental kyphotic deformity that resulted from delayed medical treatment. An anterior approach was chosen to achieve immobilization at the site of the damage before correction using the transpedicular system. Surgical correction of long-term spinal injuries in children, with the use of a combined approach, is usually laborious and traumatic. The prevention of rigid post-traumatic spine deformities with the help of timely diagnostics and appropriate treatment, including surgery, should be a priority to prevent such cases.

Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system.

In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housing an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.

Prevention and Mitigation of Radiation‐Induced Colonic Epithelial Barrier Dysfunction by Lysophosphatidic Acid Receptor‐2 Agonists

BackgroundLysophophatidic acid (LPA), a lipid growth factor, regulates secretion, absorption, cell survival and migration in the intestinal epithelium. Altered LPA activity is associated with many gastrointestinal (GI) diseases such as inflammatory bowel disease, colon cancer and GI acute radiation syndrome (GI‐ARS). Disruption of intestinal epithelial tight junctions (TJ) and gut barrier dysfunction is associated with the pathogenesis of many GI diseases. In this study, we evaluated the effect of LPA2 receptor on radiation‐induced disruption of intestinal epithelial barrier by in vivo and in vitro studies.MethodsWT and LPA2−/− mice were subjected to total body irradiation (TBI; 4Gy) or partial body irradiation (PBI‐BM5; 16 Gy). RP‐1, a stable, LPA2‐specific, LPA analog was administered (0.1 mg/kg, s.c.) 30 min prior to TBI or 24 h after PBI‐BM5. For in vitro studies, Caco‐2 and mICC12 cell monolayers were treated with LPA (10 mM) 30 min prior to irradiation (4 Gy). The barrier function was evaluated by measuring transepithelial electrical resistance (TER) and FITC‐inulin flux. TJ integrity was analyzed by immunofluorescence confocal microscopy for occludin, ZO‐1, F‐actin and claudins. Protein thiol oxidation was evaluated by measuring reduced and oxidized protein thiols by fluorescence staining using BODIPY FL‐N‐(2‐aminoethyl)maleimide as a probe. Colonic sections were also stained for Nrf2, the transcription factor responsible for regulation of antioxidant gene expression.ResultsTBI induced redistribution of TJ and AJ proteins from the epithelial junctions disruption in ileum and colon within 2 hours post irradiation (post‐IR), and the damage was sustained at least until 24 hours. TBI‐induced disruption of TJ and AJ was more severe in LPA2 −/− mice. On the other hand, RP‐1 administration in WT mice completely significantly attenuated TBI‐induced TJ and AJ disruption. PBI induced TJ disruption at 48 hours post‐IR, which was sustained at least until 100 hours. RP‐1 administered 24 h after IR mitigated PBI‐induced loss of TJ integrity. Both TBI and PBI depleted reduced protein thiols in colonic epithelium, which was blocked by RP‐1 administration. This effect of RP‐1 was associated with mitigation of PBI‐induced reduction of Nrf2 levels in colonic epithelium. In Caco‐2 and mICC12 cell monolayers, IR reduced TER, elevated inulin permeability and induced redistribution of TJ proteins in Caco‐2 and mICC12 cell monolayers. LPA (10 mM) administration, blocked IR‐induced decrease in TER, increase in inulin permeability and redistribution of TJ proteins.ConclusionThese results indicate that LPA2 receptor agonists prevent and mitigate radiation‐induced colonic epithelial barrier dysfunction. Studies in Caco‐2 and mICC12 cells indicate that LPA agonists may directly impact the intestinal epithelial cells. Supported by NIH grant DK55532

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation

BackgroundIntensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase. ObjectiveTo examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure. DesignA prospective, repeated measures design was used. MethodsTen inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial. ResultsStride length, cadence, and paretic single limb support increased with faster walking speeds (p⩽0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p⩽0.001). RPE also was greatest at the fastest compared to two slowest speeds (p<0.05). ConclusionsDuring the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds.