The Real World - Implementing High-Intensity Gait Training During Inpatient Rehabilitation Post-Stroke to Improve Outcomes

Recovery of locomotor function poststroke is a key determinant of inpatient rehabilitation discharge location. As a result, interventions targeting locomotor function are common during poststroke physical therapy, albeit with limited success. Conversely, basic and applied findings suggest maximizing the amount and cardiovascular intensity of walking practice may result in superior outcomes. This symposium will provide an overview of the evidence related to high-intensity locomotor training and previous efforts to translate this into clinical practice. Following which, this symposium will detail efforts to implement the intervention during inpatient rehabilitation poststroke at two sites (Indianapolis, Indiana and Oslo, Norway). At each site, implementation was feasible and improved locomotor outcomes without detriment to non-locomotor outcomes. Site-specific barriers, facilitators, and knowledge translation interventions will be discussed. Strategies to facilitate sustainability and lessons learned will also be reviewed with an emphasis on application to other clinical sites.