Effects of Training Intensity on Locomotor Performance in Individuals With Chronic Spinal Cord Injury: A Randomized Crossover Study.
Gabrielle Brazg, Meghan Fahey, Carey L Holleran and 5 others
PMID 29081250WHAT IT FOUND
High-intensity stepping training improved peak treadmill speed and fastest walking speed more than low-intensity training in chronic spinal cord injury.
Changes in the standard six-minute walk test did not significantly differ between the two intensities.
Key findings
01High-intensity training produced significantly greater improvements in peak treadmill speed compared to low-intensity training.
02The six-minute walk test improved with training, but the gain was not significantly different between high and low intensity.
03Fastest possible walking speed improved significantly more with high-intensity training than with low-intensity training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (15 completers), limiting the generalizability of the findings. Assessors were blinded for the six-minute walk test but not for the graded treadmill test or metabolic measures, which were primary outcomes. Individual heart rate responses varied significantly due to autonomic dysfunction or deconditioning, meaning 'intensity' was not uniformly achieved across all participants. The study was a pilot, and while differences were statistically significant, some changes in walking speed were below the minimal detectable change reported in other literature.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume high-intensity training is safe or effective for all patients with spinal cord injury. The study showed that heart rate targets were difficult to achieve for some participants due to autonomic issues, and the six-minute walk test did not significantly improve more with high intensity than low intensity.