Article

The majority of individuals poststroke recover the ability to walk overground,
although residual impairments contribute to reduced walking speed, spatiotemporal
asymmetries, inefficient gait, and limited walking activity in the home and
community. A substantial number of studies have investigated the effects of
various interventions on locomotor function in individuals poststroke; these
studies vary widely in types of tasks practiced, the amount of practiced
activities, and the intensity or workload during the intervention. In contrast,
basic and applied studies have identified specific parameters of training that
could be applied towards treatment of patients poststroke. More directly, the
specificity, amount, and intensity of walking practice are thought to be critical
variables of rehabilitation interventions that can facilitate plasticity of
neuromuscular and cardiopulmonary systems and result in improved locomotor
function. In the present commentary, we delineate the evidence and physiological
rationale for providing large amounts of high-intensity locomotor training to
improve ambulatory function in individuals poststroke. Additional evidence is
presented to indicate that improvements in non-walking tasks, such as static
balance and performance of transfers, may also occur following locomotor
training. We further evaluate previous and more recent studies in the context of
these parameters and provide suggestions for providing locomotor training for
patients with stroke in the clinical setting.

Langue : ANGLAIS