Improvement of walking ability by moderate- to high-intensity variable stepping training in a subacute stroke patient: A case report

<p>Objective: Studies have demonstrated that high-intensity stepping training incorporating various aspects of locomotion yields considerable advancement in walking ability. However, there are currently no documented practical reports of such protocols in Japan. In a previous study, high-intensity variable stepping training was conducted for a total of 40 sessions over 10 weeks. Here, we had a participant complete the same number of sessions in approximately half the time （i.e., within six weeks） provided that the system was operational 365 days a year in Japan. This report presents the results of a series of sessions conducted on a patient with subacute stroke in which the same number of sessions was performed within a reduced time frame of approximately six weeks.</p><p>Method: The case was a female in her fifties, 93 days post-morbidity after a right hemispheric stroke. The goal was to attain the capability to walk outdoors under supervision. We considered that enhancing the capacity for ambulation was essential to achieving the goal, and a program of moderate- to high-intensity variable stepping training was carried out for 40 consecutive days.</p><p>Result: The patient’s 6-minute walking distance improved by more than the minimal clinically important difference, and the goal of outdoor walking under supervision was achieved, although not to the same extent as in the previous study.</p><p>Conclusion: We demonstrated that performing the same frequency of training in approximately half the time of a prior study led to an improvement in walking ability surpassing the minimal clinically important difference.</p>