Increased comfortable gait speed is associated with improved gait biomechanics in persons with chronic stroke completing an 8-week forced-rate aerobic cycling intervention: a preliminary study.

American journal of physical medicine & rehabilitation(2023)

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摘要
Task-specific gait training is recommended to improve locomotor function post-stroke. Our objective was to determine the effects of a forced-rate aerobic exercise (FE) intervention on gait velocity and biomechanics in the absence of task-specific gait training. Individuals with chronic stroke (N = 14) underwent 24 sessions of FE, at a targeted aerobic intensity of 60-80% of their heart rate reserve. Change in comfortable walking speed in addition to spatiotemporal, kinematic, and kinetic variables were measured using 3D motion capture. Overground walking capacity was measured by the six-minute walk test (6MWT). To determine gait biomechanics associated with increased walking speed, spatiotemporal, kinematic, and kinetic variables were analyzed separately for those who met the minimal clinically important difference (MCID) for change in gait velocity compared with those who did not. Participants demonstrated a significant increase in gait velocity from 0.61 to 0.70 m/s (P = 0.004) and 6MWT distance from 272.1 to 325.1 meters (P < 0.001). Those who met the MCID for change in gait velocity demonstrated significantly greater improvements in spatiotemporal parameters (P = 0.041), ground reaction forces (P = 0.047), and power generation (P = 0.007) compared to those who did not. Improvements in gait velocity were accompanied by normalization of gait biomechanics.
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