Effects of Power and High-Intensity Gait Training for Functional Mobility an Ambulation in Chronic Stroke

NCT ID: NCT07249658

Last Updated: 2025-11-25

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-08-21
• Study Completion Date: 2026-02-21

Brief Summary

This randomized controlled trial aims to determine the combined effect of power training and high-intensity gait training on functional mobility and locomotion following chronic stroke.

Detailed Description

Stroke is one of the leading causes of long-term disability, leaving many survivors with persistent motor and gait impairments such as muscle weakness, poor coordination, stiffness, and balance deficits. These problems often manifest as trunk and pelvic asymmetry, postural imbalance, and impaired weight shifting, resulting in abnormal gait patterns and reduced independence in daily life. Such limitations highlight the urgent need for effective, evidence-based rehabilitation strategies.

Power training, which emphasizes high-velocity resistance exercises, has been shown to enhance torque development in the paretic limb and improve walking speed, endurance, and spatiotemporal gait parameters in chronic stroke survivors. Similarly, high-intensity gait training (HIGT), which involves repetitive walking at challenging intensities, has demonstrated improvements in gait quality, endurance, and lower-limb biomechanics, particularly when integrated with robotic exosuits or structured clinical protocols. Both interventions have proven effective in enhancing functional mobility and quality of life.

However, research on the combined effects of power training and HIGT remains limited. This study aims to address this gap by examining how their synergistic application can optimize locomotion, reduce long-term disability, and promote social reintegration in individuals with chronic stroke. By providing evidence for more effective rehabilitation protocols, the findings have the potential to improve patient outcomes, reduce healthcare costs, and advance clinical practice.

Conditions

Stroke

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Experimental: power training + high-intensity gait training

This group will be given a combined program that comprises gait training and lower-limb power training, three times a week. The gait component will consist of overground walking at increased intensity and treadmill training whilst using a safety harness. At the initial stage, treadmill (1.5-2.0 mph) for a duration of 2 sets,3 minutes, and 10-minute overground moderate-intensity walking is offered with frequent rests. The intensity will be gradually increased throughout the program, with an increase in speeds on the treadmill to 2.0 mph (2.5 mph or 3.0 mph) (two sets of three minutes, then three sets of 3-4 minutes, and finally 5-10 minutes at moderate and high intensity) and overground walking (10-15 min to up to 20 min at high intensity).

Group Type: EXPERIMENTAL

power training + high-intensity gait training

Intervention Type: OTHER

This group will be given a combined program that comprises gait training and lower-limb power training, which will take place three times a week. The gait component will consist of overground walking at increased intensity and treadmill training whilst using a safety harness. At the initial stage, treadmill (1.5-2.0 mph) for a duration of 2 sets,3 minutes, and 10-minute overground moderate-intensity walking is offered with frequent rests. The intensity will be gradually increased throughout the program, with an increase in speeds on the treadmill to 2.0 mph (2.5 mph or 3.0 mph) (two sets of three minutes, then three sets of 3-4 minutes, and finally 5-10 minutes at moderate and high intensity) and overground walking (10-15 min to up to 20 min at high intensity).

Control 1: power training

Individuals in the power training group will also train three times a week, including lower-limb resistance and functional strength work, applying a focus on explosive concentric effort. The exercise will consist of 3 sets (or 6 repetitions of stepping backward over a hurdle, warming up in sitting knee extension with resistance band, marching in a seat with a load on the ankle, transferring sit to stand, and hopping up on the box 46 inch). The number of sets will be increased as they are tolerated, beginning with 3 sets to 4 sets and ultimately up to 5 sets of each exercise as tolerated as the training progresses. The intensity will be progressed by raising the resistance ( box height) and performance speed.

Group Type: ACTIVE_COMPARATOR

power training

Intervention Type: OTHER

Individuals in the power training group will also train three times a week, including lower-limb resistance and functional strength work, applying a focus on explosive concentric effort. The exercise will consist of 3 sets (or 6 repetitions of stepping backward over a hurdle, warming up in sitting knee extension with resistance band, marching in a seat with a load on the ankle, transferring sit to stand, and hopping up on the box 46 inch). The number of sets will be increased as they are tolerated, beginning with 3 sets to 4 sets and ultimately up to 5 sets of each exercise as tolerated as the training progresses. The intensity will be progressed by raising the resistance ( box height) and performance speed.

Control 2: High-intensity gait training

This group will receive high-intensity gait training three days per week, taking into consideration both treadmill gait in a safety harness and overground gait. Initial training will start with a treadmill speed of 1.5 2.0 mph, two sets/3 minutes each, and 15 minutes overground walking at moderate intensity, and rest breaks when necessary. The progression will entail a gradual increase in the speeds on the treadmill to 2.0-2.5 mph (three sets of 3 minutes) and subsequently to 2.5 3.0 mph (three sets of 3 4 minutes) with the overground walking time extended to 15-20 mins and subsequently to 20 minutes at greater intensities.

Group Type: ACTIVE_COMPARATOR

high-intensity gait training

Intervention Type: OTHER

The members of this group will receive high-intensity gait training three days per week, taking into consideration both treadmill gait in a safety harness and overground gait. Initial training will start with a treadmill speed of 1.5 2.0 mph, two sets/3 minutes each, and 15 minutes overground walking at moderate intensity, and rest breaks when necessary. The progression will entail a gradual increase in the speeds on the treadmill to 2.0-2.5 mph (three sets of 3 minutes) and subsequently to 2.5 3.0 mph (three sets of 3 4 minutes) with the overground walking time extended to 15-20 mins and subsequently to 20 minutes at greater intensities.

Interventions

power training + high-intensity gait training

This group will be given a combined program that comprises gait training and lower-limb power training, which will take place three times a week. The gait component will consist of overground walking at increased intensity and treadmill training whilst using a safety harness. At the initial stage, treadmill (1.5-2.0 mph) for a duration of 2 sets,3 minutes, and 10-minute overground moderate-intensity walking is offered with frequent rests. The intensity will be gradually increased throughout the program, with an increase in speeds on the treadmill to 2.0 mph (2.5 mph or 3.0 mph) (two sets of three minutes, then three sets of 3-4 minutes, and finally 5-10 minutes at moderate and high intensity) and overground walking (10-15 min to up to 20 min at high intensity).

Intervention Type: OTHER

power training

Individuals in the power training group will also train three times a week, including lower-limb resistance and functional strength work, applying a focus on explosive concentric effort. The exercise will consist of 3 sets (or 6 repetitions of stepping backward over a hurdle, warming up in sitting knee extension with resistance band, marching in a seat with a load on the ankle, transferring sit to stand, and hopping up on the box 46 inch). The number of sets will be increased as they are tolerated, beginning with 3 sets to 4 sets and ultimately up to 5 sets of each exercise as tolerated as the training progresses. The intensity will be progressed by raising the resistance ( box height) and performance speed.

Intervention Type: OTHER

high-intensity gait training

The members of this group will receive high-intensity gait training three days per week, taking into consideration both treadmill gait in a safety harness and overground gait. Initial training will start with a treadmill speed of 1.5 2.0 mph, two sets/3 minutes each, and 15 minutes overground walking at moderate intensity, and rest breaks when necessary. The progression will entail a gradual increase in the speeds on the treadmill to 2.0-2.5 mph (three sets of 3 minutes) and subsequently to 2.5 3.0 mph (three sets of 3 4 minutes) with the overground walking time extended to 15-20 mins and subsequently to 20 minutes at greater intensities.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• 18 to 75 years of age
• more than ≥6 months of stroke onset
• first-ever unilateral ischemic stroke
• walking 10 meters independently with or without an assistive device
• being an independent ambulator (Functional Ambulation category >3)

Exclusion Criteria

• people with a history of mental/cognitive illness
• combination with peripheral neuropathy
• having resting blood pressure above 160/100 mmHg even after taking medications;
• hemorrhagic stroke
• cardiovascular comorbidity
• any musculoskeletal condition that prevents or limits the participants from doing resistance training

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Fatima Khan, MS-NMPT*

Role: PRINCIPAL_INVESTIGATOR

Riphah International Unversity

Arshad Nawaz Malik, PhD Rehab

Role: STUDY_CHAIR

Riphah International Unversity

Locations

National institute of Rehabilitation Medicine, NIRM

Islamabad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Abrish H Habib Abbasi, PhD* Rehab

Role: CONTACT

abrish.habib@riphah.edu.pk

03155311799

Facility Contacts

Fatima Khan, MS-NMPT*

Role: primary

fatimazuhair1998@gmail.com

Other Identifiers

02166 / Fatima Khan

Identifier Type: -

Identifier Source: org_study_id