Feasibility of Focused Stepping Practice During Inpatient Rehabilitation Poststroke and Potential Contributions to Mobility Outcomes.

Background: Optimal physical therapy strategies to maximize locomotor function in patients early poststroke are not well established. Emerging data indicate that substantial amounts of task-specific stepping practice may improve locomotor function, although stepping practice provided during inpatient rehabilitation is limited (<300 steps/session).

Objective: The purpose of this investigation was to determine the feasibility of providing focused stepping training to patients early poststroke and its potential association with walking and other mobility outcomes.

Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke.

The majority of individuals poststroke recover the ability to walk overground, although residual impairments contribute to reduced walking speed, spatiotemporal asymmetries, inefficient gait, and limited walking activity in the home and community. A substantial number of studies have investigated the effects of various interventions on locomotor function in individuals poststroke; these studies vary widely in types of tasks practiced, the amount of practiced activities, and the intensity or workload during the intervention. In contrast, basic and applied studies have identified specific parameters of training that could be applied towards treatment of patients poststroke.

Using compensations to assess physical performance for ambulatory outpatients.

Objective: To construct a physical performance scale for community-dwelling ambulatory outpatients that is linear, includes high functioning tasks, and uses common compensations to assess difficulty levels.

Design: Calibrated subject performances on 19 tasks were rated by an examiner, timed, and had compensations recorded.

Setting: Ambulatory outpatient physical therapy (PT) department of a tertiary care center.