PTOTSLPRCTArchives of physical medicine and rehabilitation2026

Quantifying Exercise Intensity to Predict Changes in Walking Capacity in Individuals with Chronic Stroke.

Kiersten M McCartney, Pierce Boyne, Ryan Pohlig and 2 others

PMID 40915558

WHAT IT FOUND

Training speed predicted walking gains in chronic stroke, but heart rate did not.

Walking at a patient's fastest speed yielded larger improvements than their normal pace. Clinicians should target speed, not just heart rate, to maximize endurance and velocity.

Key findings

01Average training speed was a significant predictor of changes in both fastest walking speed and six-minute walk distance, while average heart rate reserve was not.

02Patients who trained at their fastest walking speed saw greater improvements in endurance and speed compared to those training at their self-selected speed.

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

This was a secondary analysis, not a direct comparison of speed versus heart rate interventions; heart rate was the prescribed target, but speed varied naturally. Step counts were not recorded during training, so the role of repetition versus intensity could not be separated. Maximal heart rate was measured only once at baseline and not adjusted during the 12 weeks, potentially skewing intensity calculations if fitness improved. The study did not determine when within the intervention the walking speed improvements occurred, so training targets were not dynamically adjusted to the patient's improving capacity.

Declared interests

None to disclose.

The easy way to misread this

Do not assume that higher heart rate is useless for cardiovascular health. This study shows heart rate did not predict *walking capacity* gains, but it does not prove heart rate is irrelevant to aerobic fitness or other health outcomes in this population.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →