Immediate and long-term functional impact of repetitive locomotor training as an adjunct to conventional physiotherapy for non-ambulatory patients after stroke

Purpose. The aim of the present study was to assess the heart rate intensity during gait training and to evaluate the relationship between heart rate intensity during gait training and walking ability of patients after stroke. Methods. We included non-ambulatory patients within six weeks after first stroke. Over four weeks patients were trained five times a week, with either 20 minutes of repetitive locomotor training and 25 min of physiotherapy (RLT-PT), or 45 min of PT alone. We assessed the heart rate intensity during training period. Additionally we assessed walking ability (Functional Ambulation Categories) and the rate of independent ability to perform activities of daily life (Barthel Index) at the end of study and six months and three years later on. Results. We included 30 patients in each group. Patients in RLT-PT group exercised longer in the HR target zone than in the PT group (16.1 +/- 11.8 min vs. 5.3 +/- 5.6 min, p < 0.001). Higher heart rates were associated with independent walking at the end of study, at six months and at three years after the end of study (Fishers exact test, p = 0.014, p = 0.012 and p = 0.017, respectively). Conclusions. Higher heart rate intensities during gait-training of non-ambulatory post-stroke patients may improve walking function.