Abstract

High Intensity Group Gait Training: Is it Intense Enough?

Background and purpose: Research indicates that high intensity gait training promotes walking recovery and neuroplasticity following neurological injury. The aim of this study was to assess the feasibility and effectiveness of implementing intensive gait training using a group model. Methods: 50 individuals completing outpatient therapy following neurological injury were recruited. All participants had to be able to ambulate for at least 10 min continuously (Goal of 30 min total) without physical assistance from a therapist. These participants were placed in groups of 2-4 with one therapist, and a goal to ambulate at 60-80% maximum heart rate. Heart Rates (HR) and RPEs (Rate of Perceived Exertion) were monitored throughout the session as participants were ambulating. Results: For all group configurations, average intensities were within the target range. Statistical analysis revealed that for those participants whose HR was monitored, groups of 2 and 3 showed slightly higher averages than those in groups of 1 or 4. For participants whose intensity was monitored via RPE, groups of 3 and 4 showed a significantly higher average RPE compared to those in groups of 1-2 (P4>P1 (p=0.025) and P3>P1 (p=0.057). Discussion and conclusions: For all group sizes, gait training is feasible and effective without sacrificing intensity. Furthermore, for participants who received a minimum of five training sessions, 86% demonstrated improvements of at least 1 MCID in functional outcomes. While one cannot draw direct causation, there does seem to be a benefit of completing training in a group.


Author(s):

Laura H Lenhart



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