HIGT

• Successful propulsion is directional advancement of the COM>
• Successful limb advancement is a positive step length or swing leg surpassing the stance leg.
• Successful stance control is absence of limb or trunk collapse while stepping.
• Successful lateral stability is maintaining upright posture or not losing balance while stepping.
• Guidance is assigned if the patient is unsuccessful most of the time (1-4 reps).
• Assist as needed is assigned if the patient is unsuccessful most of the time (4-5 out of 10).
• Trial and error is assigned is the patient is successful some of the time (6/10).
• Error augmentation is assigned if the patient is successful most of the time (7 or more out of ten).
• Failure is an inability to meet the minimum criteria for success in each subcomponent without pain about half of the time.
• Gait training should be performed at 70-85% of max heart rate.
• Measure intensity through the cardiovascular response (vitals), patient-report (RPE), and visual appraisal.
• To challenge propulsion, increase speed, go to the stairs, or resist walking.
• To challenge stance control, wear a weight vest, decrease assistance from devices, or walk on variable surfaces.
• To challenge lateral stability, decrease upper extremity support, perform side-stepping, or use external forces.
• To challenge limb swing, move to the stairs, give the patient ankle weights, use hurdles, or add theraband resistance.
• Common beta-blockers will end in -lol.
• Consider pacemakers when calculating intensity.
• Consider cardiovascular history, like Afib, when calculating intensity.
• Body-weight support harnesses will take weight away from the patient. These are used if the patient has significant stance deficits.
• Fall prevention harnesses are used if the patient has really poor lateral stability, but can still stand upright on their own.
• Chronic stoke patients should perform gait training at moderate to high intensities and gait training with VR.
• Chronic stroke patients may perfrom strength training at more than 70% 1 rep max, aerobic training other than walking at 75-85% HR max, and balance training with VR.
• Chronic stroke patient should not perform static or balance activities, body weight support treadmill training, and robot-assisted gait training.
• Chronic stroke patients should only perform the yellow light activities at home if they refuse to participate in green light activities, or if they have not been cleared medically.
• Practicing abnormal gait eventually elicited normal movement patterns.
• The goal of treatment in the acute phase is to get up and moving.
• The goal of treatment in the subacute phase is to keep moving and begin to ramp up intensity.
• The goal of the chronic phase is to move a lot at higher intensities.