Longitudinal spatiotemporal gait changes following maximal speed locomotor training in individuals with chronic stroke

Darcy Reisman, Pierce Boyne, Daria Pressler, Sarah Schwab-Farrell, Sandra Billinger
Purpose:

This study assessed longitudinal changes in spatiotemporal gait parameters following short-burst HIIT versus moderate-intensity aerobic training (MAT) in chronic stroke. Compared to MAT, short-burst HIIT was hypothesized to exhibit greater improvement in non-paretic step length. 

Methods:

The HIT-Stroke Trial randomized 55 participants with chronic stroke to short-burst HIIT (N=27) or MAT (N=28) for 45 minutes of walking practice, 3 times weekly, over 12 weeks. This secondary analysis compared mean changes in spatiotemporal gait parameters between groups using the average of the 4, 8, and 12-week changes from baseline. The primary measure of interest was non-paretic step length, an indicator of paretic propulsion and biomechanical efficiency.

Results:

Non-paretic step length increased significantly more in the HIIT group (+4.4 cm [95% CI, 1.9, 6.9]) compared to the MAT group (+0.1 [-2.5, 2.7]; HIIT vs MAT p=.01). Both HIIT and MAT groups had significant increases in cadence (HIIT +9.1 steps/min [5.0, 13.2]; MAT +6.4 [0.1, 10.6]), paretic step length (HIIT +4.8 cm [2.7, 6.8]; MAT +4.6 [2.5, 6.7]), paretic single support time (HIIT +1.7 % gait cycle [0.6, 2.8]; MAT +1.6 [0.4, 2.8]), and non-paretic single support time (HIIT +4.0 % gait cycle [2.7 to 5.4]; MAT +2.5 [1.1, 4.0]). Both groups also showed significant decreases in the coefficient of variation (CV) for stride velocity (HIIT -2.7% [-4.3, -1.1]; MAT -2.6 [-4.3, -0.9]), stride time (HIIT -2.4% [-3.7, -1.0]; MAT -2.3 [-3.7, -0.9]), and stride length (HIIT -1.5% [-2.5, -0.5]; MAT -1.4 [-2.5, -0.4]). No significant changes in symmetry measures were observed in either group.

Conclusion(s):

Greater increases in non-paretic step length demonstrated with short-burst HIIT compared to MAT suggest that training at maximal speeds may yield greater increases in paretic propulsion, a marker of biomechanical efficiency. Both moderate and maximal speed locomotor training (MAT and HIIT) appear to reduce spatiotemporal variability, possibly indicating improved gait stability.

Implications:

Maximal speed locomotor training elicits spatiotemporal changes which may indicate improved biomechanical efficiency and gait stability in chronic stroke.

Funding acknowledgements:
This research was supported by grant R01HD093694 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Keywords:
Gait
HIIT
Biomechanics
Primary topic:
Neurology: stroke
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
University of Cincinnati Institutional Review Board
Provide the ethics approval number:
2017-5325
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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