R2. Improving Delivery of Intensive Gait Training in the Clinical setting to Augment Community Ambulation
George Hornby, Ph.D, P.T.
is a randomized, controlled, single-blinded clinical trial on the effects of
large doses of high intensity locomotor training performed on a treadmill
and over-ground in individuals less than 6 months post-stroke, as compared to
conventional physical therapy as performed in the clinical setting. Subjects
are stratified according to the extent of walking impairments after stroke, and
randomized to receive 8-10 weeks of either the experimental training or
conventional physical therapy.
therapy is provided in the clinical setting by a licensed therapist, with training
protocols determined by the treating therapist, the patient, and their
family/caregivers, without consultation from the research group. Patients
receiving conventional therapy for 8-10 weeks may be eligible to receive
experimental training for 4 weeks.
experimental training will be provided inside the Rehabilitation Institute of
Chicago, and will consist of continuous upright stepping performed over-ground,
on a treadmill, or on stairs. Over-ground walking will consist of level
walking at variable speeds, in multiple directions, with variable assistance or
resistance to perform these tasks. Other tasks performed during
over-ground training can include dual tasking, walking over uneven surfaces, or
balance beam walking. Treadmill walking will also be performed at variable
speeds, in multiple directions and with variable assistance or
resistance. Stair climbing will be performed in a staircase, or on a
“stair treadmill”. Heart rate and perceived exertion will be
monitored throughout the training.
outcome measures include standard measures of over-ground walking speed and
distance, peak treadmill speed, and walking activity in the community.
Secondary outcome measures include volitional strength, balance, energy
consumption, and ability to safely and rapidly rise from a chair.