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Abstract:
Abstract: Recent animal work has revealed that behavioral
experience can promote neuroplasticity and functional recovery
after brain damage. It has been suggested that the intensity and
specificity of the motor training may be critical attributes that
affect behavioral outcomes (Jones et al, 1999; Nudo et al, 1996).
Treadmill training with body-weight support was used to examine the
effect of training specificity and intensity on locomotor recovery
after stroke. Training intensity was varied as a function of
walking speed. Stroke subjects were randomly assigned to one of 3
training intensity groups (low,.5 mph; high,2.0 mph;
variable;.5,1.0,1.5,2.0 mph varied within session). Training
frequency and duration were constant across groups (12 training
sessions/4 wks). Subjects returned for a 1-month follow-up.
Preliminary results of 19 subjects (stroke onset: 26±17 mos;
pretraining velocity: .53±.29 m/s) reveals that for all
groups overground gait velocity improved with training (Block
effect: p<.01). However, the greatest improvement in
overground velocity was related to training intensity (%
improvement: low, 5%; high, 28%, variable, 15%). Effect size was
large between low and high intensity groups (ES: 1.05) and moderate
between low and variable groups (ES: .63). For all groups,
improvements in gait speed were evident at the 1-mo follow-up (mean
increase 12.7%; p<.01). Task specific training with high
intensity promotes the greatest degree of behavioral locomotor
recovery post-stroke. Supported by a McDonnell-Pew grant to
BJK.
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