High-intensity locomotor training during inpatient rehabilitation improves the discharge ambulation function of patients with stroke. A systematic review with meta-analysis

References

• Hornby TG, Reisman DS, Ward IG, et al. Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury. J Neurol Phys Ther. 2020;44(1):49–100. doi:10.1097/NPT.0000000000000303.
   PubMed Web of Science ®Google Scholar
• Moore JL, Roth EJ, Killian C, Hornby TG. Locomotor training improves daily stepping activity and gait efficiency in individuals poststroke who have reached a “plateau” in recovery. Stroke. 2010;41(1):129–135. doi:10.1161/STROKEAHA.109.563247.
   PubMed Web of Science ®Google Scholar
• Hornby T, Straube D, Kinnaird C, et al. Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke. Top Stroke Rehabil. 2011;18(4):293–307. doi:10.1310/tsr1804-293.
   PubMed Web of Science ®Google Scholar
• Holleran CL, Straube DD, Kinnaird CR, Leddy AL, Hornby TG. Feasibility and potential efficacy of high-intensity stepping training in variable contexts in subacute and chronic stroke. Neurorehabil Neural Repair. 2014;28(7):643–651. doi:10.1177/1545968314521001.
   PubMed Web of Science ®Google Scholar
• Hornby TG, Henderson CE, Plawecki A, et al. Contributions of stepping intensity and variability to mobility in individuals poststroke. Stroke. 2019;50(9):2492–2499. doi:10.1161/STROKEAHA.119.026254.
   PubMed Web of Science ®Google Scholar
• Fahey M, Brazg G, Henderson CE, et al. The value of high intensity locomotor training applied to patients with acute-onset neurologic injury. Arch Phys Med Rehabil. 2022;103(7):S178–S188. doi:10.1016/j.apmr.2020.09.399.
   PubMed Web of Science ®Google Scholar
• Hornby TG, Holleran CL, Hennessy PW. Variable intensive early walking poststroke (VIEWS): a randomized controlled trial. Neurorehabil Neural Repair. 2016;30(4):440–450. doi:10.1177/1545968315604396.
   PubMedGoogle Scholar
• Ivey FM, Stookey AD, Hafer-Macko CE, Ryan AS, Macko RF. Higher treadmill training intensity to address functional aerobic impairment after stroke. J Stroke Cerebrovasc Dis. 2015;24(11):2539–2546. doi:10.1016/j.jstrokecerebrovasdis.2015.07.002.
   PubMed Web of Science ®Google Scholar
• Luft AR, Macko RF, Forrester LW, et al. Treadmill exercise activates subcortical neural networks and improves walking after stroke: a randomized controlled trial. Stroke. 2008;39(12):3341–3350. doi:10.1161/strokeaha.108.527531.
   PubMed Web of Science ®Google Scholar
• Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36(10):2206–2211. doi:10.1161/01.str.0000181076.91805.89.
   PubMed Web of Science ®Google Scholar
• Steen Krawcyk R, Vinther A, Petersen NC, et al. Effect of home-based high-intensity interval training in patients with lacunar stroke: a randomized controlled trial. Front Neurol. 2019;10:10. doi:10.3389/fneur.2019.00664.
   PubMed Web of Science ®Google Scholar
• Sandberg K, Kleist M, Falk L, Enthoven P. Effects of twice-weekly intense aerobic exercise in early subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2016;97(8):1244–1253. doi:10.1016/j.apmr.2016.01.030.
   PubMed Web of Science ®Google Scholar
• Mah SM, Goodwill AM, Seow HC, Teo WP. Evidence of High-Intensity Exercise on Lower Limb Functional Outcomes and Safety in Acute and Subacute Stroke Population: A Systematic Review. Int J Environ Res Public Health. 2022;20(1):153. doi:10.3390/ijerph20010153.
   PubMed Web of Science ®Google Scholar
• Jolliffe L, Lannin NA, Cadilhac DA, Hoffmann T. Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries. BMJ Open. 2018;8(2):e018791. doi:10.1136/bmjopen-2017-018791.
   PubMed Web of Science ®Google Scholar
• Prvu Bettger JA, Stineman MG. Effectiveness of multidisciplinary rehabilitation services in postacute care: state-of-the-science. A review. Arch Phys Med Rehabil. 2007;88(11):1526–1534. doi:10.1016/j.apmr.2007.06.768.
   PubMed Web of Science ®Google Scholar
• Chan L, Sandel ME, Jette AM, et al. Does postacute care site matter? A longitudinal study assessing functional recovery after a stroke. Arch Phys Med Rehabil. 2013;94(4):622–629. doi:10.1016/j.apmr.2012.09.033.
   PubMedGoogle Scholar
• Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47(6):e98–e169. doi:10.1161/STR.0000000000000098.
   PubMed Web of Science ®Google Scholar
• Duncan P, Zorowitz R, Bates B, et al. Management of Adult Stroke Rehabilitation Care: a clinical practice guideline. Stroke. 2005;36(9). doi:10.1161/01.STR.0000180861.54180.FF.
   Web of Science ®Google Scholar
• Grau-Pellicer M, Chamarro-Lusar A, Medina-Casanovas J, Serdà Ferrer BC. Walking speed as a predictor of community mobility and quality of life after stroke. Top Stroke Rehabil. 2019;26(5):349–358. doi:10.1080/10749357.2019.1605751.
   PubMed Web of Science ®Google Scholar
• Middleton A, Graham JE, Prvu Bettger J, Haas A, Ottenbacher KJ. Facility and geographic variation in rates of successful community discharge after inpatient rehabilitation among medicare fee-for-service beneficiaries. JAMA Netw Open. 2018;1(7):e184332. doi:10.1001/jamanetworkopen.2018.4332.
   PubMed Web of Science ®Google Scholar
• Chevalley O, Truijen S, Opsommer E, Saeys W. Physical functioning factors predicting a return home after stroke rehabilitation: a systematic review and meta-analysis. Clin Rehabil. 2023;37(12):1698–1716. doi:10.1177/02692155231185446.
   PubMed Web of Science ®Google Scholar
• Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160. doi:10.1136/bmj.n160.
   PubMed Web of Science ®Google Scholar
• Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi:10.1136/bmj.l4898.
   PubMed Web of Science ®Google Scholar
• Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the cochrane handbook for systematic reviews of interventions. Cochrane editorial unit, ed. Cochrane Database Syst Rev. 2019 October 3. doi:10.1002/14651858.ED000142.
   PubMed Web of Science ®Google Scholar
• Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. doi:10.1136/bmj.i4919.
   PubMed Web of Science ®Google Scholar
• Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. doi:10.1136/bmj.327.7414.557.
   PubMed Web of Science ®Google Scholar
• Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. NJ: Erlbaum; 1988.
   Google Scholar
• Klassen TD, Dukelow SP, Bayley MT, et al. Higher doses improve walking recovery during stroke inpatient rehabilitation. Stroke. 2020;51(9):2639–2648. doi:10.1161/STROKEAHA.120.029245.
   PubMed Web of Science ®Google Scholar
• Bowden MG, Monsch ED, Middleton A, Daughtry C, Powell T, Kraft SV. Lessons learned: the difficulties of incorporating intensity principles into inpatient stroke rehabilitation. Arch Rehabil Res Clin Transl. 2020;2(2):100052. doi:10.1016/j.arrct.2020.100052.
   PubMedGoogle Scholar
• Kuys S, Brauer S, Ada L. Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: a pilot randomized trial. Clin Rehabil. 2011;25(4):316–326. doi:10.1177/0269215510382928.
   PubMed Web of Science ®Google Scholar
• Eich HJ, Mach H, Werner C, Hesse S. Aerobic treadmill plus bobath walking training improves walking in subacute stroke: a randomized controlled trial. Clin Rehabil. 2004;18(6):640–651. doi:10.1191/0269215504cr779oa.
   PubMed Web of Science ®Google Scholar
• Pallesen H, Bjerk M, Pedersen AR, Nielsen JF, Evald L. The effects of high-intensity aerobic exercise on cognitive performance after stroke: a pilot randomised controlled trial. J Cent Nerv Syst Dis. 2019;11:1179573519843493. doi:10.1177/1179573519843493.
   Web of Science ®Google Scholar
• Moore JL, Nordvik JE, Erichsen A, et al. Implementation of high-intensity stepping training during inpatient stroke rehabilitation improves functional outcomes. Stroke. 2020;51(2):563–570. doi:10.1161/STROKEAHA.119.027450.
   PubMed Web of Science ®Google Scholar
• Henderson CE, Plawecki A, Lucas E, et al. Increasing the amount and intensity of stepping training during inpatient stroke rehabilitation improves locomotor and non-locomotor outcomes. Neurorehabil Neural Repair. 2022;36(9):621–632. doi:10.1177/15459683221119759.
   PubMed Web of Science ®Google Scholar
• Hornby TG, Holleran CL, Leddy AL, et al. Feasibility of focused stepping practice during inpatient rehabilitation poststroke and potential contributions to mobility outcomes. Neurorehabil Neural Repair. 2015;29(10):923–932. doi:10.1177/1545968315572390.
   PubMed Web of Science ®Google Scholar
• Henderson CE, Fahey M, Brazg G, Moore JL, Hornby TG. Predicting discharge walking function with high-intensity stepping training during inpatient rehabilitation in nonambulatory patients poststroke. Arch Phys Med Rehabil. 2022;103(7):S189–S196. doi:10.1016/j.apmr.2020.10.127.
   PubMed Web of Science ®Google Scholar
• Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33(1):159–174. doi:10.2307/2529310.
   PubMed Web of Science ®Google Scholar
• American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.
   Google Scholar
• Perera S, Mody SH, Woodman RC, Studenski SA. Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc. 2006;54(5):743–749. doi:10.1111/j.1532-5415.2006.00701.x.
   PubMed Web of Science ®Google Scholar
• Fulk GD, He Y, Boyne P, Dunning K. Predicting home and community walking activity poststroke. Stroke. 2017;48(2):406–411. doi:10.1161/STROKEAHA.116.015309.
   PubMed Web of Science ®Google Scholar
• Rajsic S, Gothe H, Borba HH, Sroczynski G, Vujicic J, Toell T. Economic burden of stroke: a systematic review on post-stroke care. Eur J Health Econ. 2019;20(1):107–134. doi:10.1007/s10198-018-0984-0.
   PubMed Web of Science ®Google Scholar
• Tilson JK, Sullivan KJ, Cen SY, et al. Meaningful gait speed improvement during the first 60 days poststroke: minimal clinically important difference. Phys Ther. 2010;90(2):196–208. doi:10.2522/ptj.20090079.
   PubMed Web of Science ®Google Scholar
• Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke. 1995;26(6):982–989. doi:10.1161/01.str.26.6.982.
   PubMed Web of Science ®Google Scholar
• Bowden M, Balasubramanian C, Behrman A, Kautz S. Validation of a speed-based classification system using quantitative measures of walking performance poststroke. Neurorehabil Neural Repair. 2008;22(6):672–675. doi:10.1177/1545968308318837.
   PubMed Web of Science ®Google Scholar
• Schmid A, Duncan P, Studenski S, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096–2100. doi:10.1161/STROKEAHA.106.475921.
   PubMed Web of Science ®Google Scholar
• Magdon-Ismail Z, Ledneva T, Sun M, et al. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Top Stroke Rehabil. 2018;25(8):576–583. doi:10.1080/10749357.2018.1499303.
   PubMed Web of Science ®Google Scholar
• Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards CL. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil. 2001;82(9):1204–1212. doi:10.1053/apmr.2001.24907.
   PubMed Web of Science ®Google Scholar
• Stevenson TJ. Detecting change in patients with stroke using the berg balance scale. Aust J Physiother. 2001;47(1):29–38. doi:10.1016/s0004-9514(14)60296-8.
   PubMed Web of Science ®Google Scholar
• Doğğan A, Mengüllüoğğlu M, Özgirgin N. Evaluation of the effect of ankle-foot orthosis use on balance and mobility in hemiparetic stroke patients. Disabil Rehabil. 2011;33(15–16):1433–1439. doi:10.3109/09638288.2010.533243.
   PubMed Web of Science ®Google Scholar
• Langhorne P, Stott DJ, Robertson L, et al. Medical complications after stroke. Stroke. 2000;31(6):1223–1229. doi:10.1161/01.STR.31.6.1223.
   PubMed Web of Science ®Google Scholar
• Indredavik B, Rohweder G, Naalsund E, Lydersen S. Medical complications in a comprehensive stroke unit and an early supported discharge service. Stroke. 2008;39(2):414–420. doi:10.1161/STROKEAHA.107.489294.
   PubMed Web of Science ®Google Scholar
• McLean DE. Medical complications experienced by a cohort of stroke survivors during inpatient, tertiary-level stroke rehabilitation. Arch Phys Med Rehabil. 2004;85(3):466–469. doi:10.1016/S0003-9993(03)00484-2.
   PubMed Web of Science ®Google Scholar
• Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke. 2001;32(2):523–529. doi:10.1161/01.str.32.2.523.
   PubMed Web of Science ®Google Scholar
• Balinski M, Madhavan S. “Magic” number of treadmill sessions needed to achieve meaningful change in gait speed after stroke: a systematic review. Am J Phys Med Rehabil. 2022;101(9):826–835. doi:10.1097/PHM.0000000000001920.
   PubMed Web of Science ®Google Scholar