RT Journal Article SR Electronic T1 Effects of Dynamic Stepping Training on Nonlocomotor Tasks in Individuals Poststroke JF Physical Therapy JO Phys Ther FD American Physical Therapy Association SP 921 OP 933 DO 10.2522/ptj.20130544 VO 94 IS 7 A1 Straube, Don D. A1 Holleran, Carey L. A1 Kinnaird, Catherine R. A1 Leddy, Abigail L. A1 Hennessy, Patrick W. A1 Hornby, T. George YR 2014 UL http://jcore-reference.highwire.org/content/94/7/921.abstract AB Background During the physical rehabilitation of individuals poststroke, therapists are challenged to provide sufficient amounts of task-specific practice in order to maximize outcomes of multiple functional skills within limited visits. Basic and applied studies have suggested that training of one motor task may affect performance of biomechanically separate tasks that utilize overlapping neural circuits. However, few studies have explicitly investigated the impact of training one functional task on separate, nonpracticed tasks. Objective The purpose of this preliminary study was to investigate the potential gains in specific nonlocomotor assessments in individuals poststroke following only stepping training of variable, challenging tasks at high aerobic intensities. Methods Individuals with locomotor deficits following subacute and chronic stroke (n=22) completed a locomotor training paradigm using a repeated-measures design. Practice of multiple stepping tasks was provided in variable environments or contexts at high aerobic intensities for ≥40 sessions over 10 weeks. The primary outcome was timed Five-Times Sit-to-Stand Test (5XSTS) performance, with secondary measures of sit-to-stand kinematics and kinetics, clinical assessment of balance, and isometric lower limb strength. Results Participants improved their timed 5XSTS performance following stepping training, with changes in selected biomechanical measures. Statistical and clinically meaningful improvements in balance were observed, with more modest changes in paretic leg strength. Conclusions The present data suggest that significant gains in selected nonlocomotor tasks can be achieved with high-intensity, variable stepping training. Improvements in nonpracticed tasks may minimize the need to practice multiple tasks within and across treatment sessions.