Effects of Task-Specific Locomotor and Strength Training in Adults Who Were Ambulatory After Stroke: Results of the STEPS Randomized Clinical Trial

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

“…[225][226][227][228][229][230][231] In 2 RCTs, individuals receiving bodyweight support treadmill training improved their overground walking speed compared with those practicing usual overground walking. 225,228 McCain and colleagues 228 found walking improvements not only on the 6-minute walk test but also in gait kinematics; however, a metaanalysis yielded conflicting evidence regarding whether body-weight support treadmill training improved walking and motor recovery compared with conventional therapy.…”

“…For example, 2 studies reported no significant improvements in gait speed after LE resistive strengthening. 230,246 According to a recent study, the most important muscle group on the hemiparetic leg that predicts gait speed is the knee extensors 247 ; therefore, interventions that target increased gait speed should focus on the hemiparetic knee extensors to maximize walking outcomes. A 2008 systematic review 248 concluded that LE strengthening interventions improve strength and activity without increasing spasticity.…”

Task‐specific training: evidence for and translation to clinical practice

“…However, most of the taskspecifi c training evidence relates to post-stroke recovery. It has been found to be effective in cognitive neurorehabilitation (Calvanio et al, 1993), sensory retraining (Carey et al, 1993), gait retraining (Hesse, 1999;Peurala et al, 2004;Sullivan et al, 2007), sit-to-stand retraining (Canning et al, 2003) and motor training of the upper limb (Feys et al, 1998;Byl et al, 2003;Blennerhassett and Dite, 2004;Page et al, 2004Page et al, , 2005Hakkennes and Keating, 2005;WoodDauphinee and Kwakkel, 2005;Michaelsen et al, 2006;Wolf et al, 2006). Task-specifi c training is a core element of a number of interventions, as discussed below.…”

Design of the multicenter standardized supervised exercise training intervention for the ‘CLaudication: Exercise Vs Endoluminal Revascularization (CLEVER) study’

“…These studies have often collected subject compliance and attendance rates post-hoc, but clinical exercise sites have not been actively monitored or trained by a central committee throughout the study period. Notable exceptions from this usual trial design were achieved in the HERITAGE, 21 Strength Training Effectiveness Post Stroke trial (STEPS), 30 Effects of eXErcise Training in participants with heart failure trial (EXERT), 27 and HF-ACTION 20 trials, which have included training and certification procedures for participating clinical sites. CLEVER procedures for these elements of the program were based in part on the experience of these prior studies.…”