Volume 7, Issue 3 (2022)                   IJMPP 2022, 7(3): 730-740 | Back to browse issues page


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Motaqi M, Ghanjal A, Afrand M. Treadmill Exercise and its Effect on Rehabilitation of Patients after Ischemic strok: A Narrative Study. IJMPP. 2022; 7 (3) :730-740
URL: http://ijmpp.modares.ac.ir/article-32-61870-en.html
1- Physiotherapy Research Center, School of Rehabilitation, Shahid Be- heshti University of Medical Scienc- es,Tehran, Iran. , dr.motaqi@gmail.com
2- Health Management Research Cen- ter, Baqiyatallah University of Medical Sciences, Tehran, Iran
3- Roya Physiotherapy clinic, Tehran, Iran
Abstract:   (190 Views)
Aim: Stroke is the third leading cause of death after cardiovascular disease and cancer. Stroke causes disability in various forms in sufferers. It has been suggested that various pathological mechanisms are involved in causing this injury. Articles show that regular exercise is a way to treat stroke patients. One of the most common exercise therapy models is treadmill exercise.However, there is still controversy about when to start   treadmill workouts, the intensity of the workout, the type of treadmill workout, and how it has positive effects. This article offers an overview of treadmill exercise and its’ effects on post-ischemic stroke rehabilitation. In this study, the effect of exercise time, exercise intensity, exercise style, and the positive effects of this type of exercise on rehabilitation of patients after ischemic stroke were briefly examined.
Full-Text [PDF 575 kb]   (29 Downloads)    
Article Type: Descriptive & Survey | Subject: Musculoskeletal Pain Prevention
Received: 2022/05/29 | Accepted: 2022/06/14 | Published: 2022/06/30

References
1. Han P , Zhang W , Kang L , Ma Y , Fu L , Jia L , et.al. Clinical Evidence of Exercise Benefits for Stroke. Adv Exp Med Biol 2017;1000:131-151. [DOI:10.1007/978-981-10-4304-8_9]
2. VanGilder RL , Davidov DM , Stinehart KR , Huber JD , Turner RC , Wilson KS ,et.al. C-reactive protein and long-term ischemic stroke prognosis. J Clin Neurosci 2014;21(4):547-53. [DOI:10.1016/j.jocn.2013.06.015]
3. Doyle KP, Simon RP, Stenzel-Poore MP. Mechanisms of ischemic brain damage. Neuropharmacology 2008;55(3):310-8. [DOI:10.1016/j.neuropharm.2008.01.005]
4. Finch E , Hayward KS, Fleming J, Copland DA. Identifying implications of thrombolysis for stroke rehabilitation: knowledge gaps in currentresearch. Disabil Rehabil 2013;35(11):924-30. [DOI:10.3109/09638288.2012.726315]
5. Pianta S , Lee JY , Tuazon JP , Castelli V , Mantohac LM , Tajiri N ,et.al A. Short Bout of Exercise Prior to Stroke Improves Functional Outcomes by Enhancing Angiogenesis. Neuromolecular Med 2019;21(4):517-528. [DOI:10.1007/s12017-019-08533-x]
6. Nie J, Yang X , Tang Q , Shen Q , Li S. Willedmovement training reduces brain damage and enhances synaptic plasticity related proteins synthesis after focal ischemia. Brain Res Bull 2016;120:90-6. [DOI:10.1016/j.brainresbull.2015.11.004]
7. Luo CX , Jiang J, Gang Zhou Q, Zhu XJ, Wang W, Zhang ZJ,et.al. Voluntary exercise-induced neurogenesis in the postischemic dentate gyrus is associated with spatial memory recovery from stroke. J Neurosci Res 2007;85(8):1637-46. [DOI:10.1002/jnr.21317]
8. Tian S , Zhang Y, Tian S, Yang X, Yu K, Zhang Y, et.al. Early exercise training improves ischemic outcome in rats by cerebral hemodynamics. Brain Res. Brain Res 2013;1533:114-21. [DOI:10.1016/j.brainres.2013.07.049]
9. Yang YR , Wang RY, Shyi-Gang Wang P. Early and late treadmill training after focal brain ischemia in rats. Neurosci Lett 2003;339(2):91-4. [DOI:10.1016/S0304-3940(03)00010-7]
10. Nielsen RK, Samson KL, Simonsen D, Jensen W. Effect of early and late rehabilitation onset in a chronic rat model of ischemic stroke- assessment of motor cortex signaling and gait functionality over time. IEEE Trans Neural Syst Rehabil Eng 2013;21(6):1006-15. [DOI:10.1109/TNSRE.2013.2279375]
11. Linder SM , Rosenfeldt AB , Davidson S , Zimmerman N , Penko A , Lee J ,et.al. Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke. Neurorehabil Neural Repair 2019;33(8):681- 690. [DOI:10.1177/1545968319862557]
12. Heo M , Kim E. Beneficial effects of antecedent exercise training on limb motor function and calpain expression in a rat model of stroke. J Phys Ther Sci 2013;25(8):943-6. [DOI:10.1589/jpts.25.943]
13. Bernhardt J , Dewey H, Thrift A, Collier J, Donnan G. A very early rehabilitation trial for stroke (AVERT): phase II safety and feasibility. Stroke 2008;39(2):390-6. [DOI:10.1161/STROKEAHA.107.492363]
14. Morreale M , Marchione P, Pili A , Lauta A , Castiglia SF, Spallone A ,et.al. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?. Eur J Phys Rehabil Med 2016;52(1):81-9.
15. Buiatti de Araujo FL, Bertolino G, Rodrigues Funayama CA, Coimbra NC, deAraujo JE. Influence of treadmill training on motor performance and organization of exploratory behavior in Meriones unguiculatus with unilateral ischemic stroke: histological correlates in hippocampal CA1 region and the neostriatum. eurosci Lett 2008;431(2):179-83. [DOI:10.1016/j.neulet.2007.11.038]
16. Zhang P, Xianglei J, Hongbo Y, Zhang J, Xu C. Neuroprotection of early locomotor exercise poststroke: evidence from animal studies. Can J Neurol Sci 2015;42(4):213-20. [DOI:10.1017/cjn.2015.39]
17. Zhang P, Zhang Y, Zhang J, Wu Y, Jia J, Wu J, Hu Y. Early exercise protects against cerebral ischemic injury through inhibiting neuron apoptosis in cortex in rats. Int J Mol Sci 2013;14(3):6074-89. [DOI:10.3390/ijms14036074]
18. Yang L, Zhang J, Deng Y, Zhang P. The effects of early exercise on motor, sense, and memory recovery in rats with stroke. Am J Phys Med Rehabil 2017;96(3):e36-e43. [DOI:10.1097/PHM.0000000000000670]
19. Hubbard IJ, Carey LM, Budd TW, Levi C, McElduff P, Steven Hudson, et.al. A randomized controlled trial of the effect of early upper-limb training on stroke recovery and brain activation. Neurorehabil Neural Repair 2015;29(8):703-13. [DOI:10.1177/1545968314562647]
20. Risedal A, Zeng J, Johansson BB.Early training may exacerbate brain damage after focal brain ischemia in the rat. J Cereb Blood Flow Metab 1999;19(9):997-1003. [DOI:10.1097/00004647-199909000-00007]
21. Li F, Pendy Jr JT, Ding JN, Changya Peng C, Li X, Shen J, et.al. Exercise rehabilitation immediately following ischemic stroke exacerbates inflammatory injury. Neurol Res 2017;39(6):530- 537. [DOI:10.1080/01616412.2017.1315882]
22. Li F, Shi W, Zhao EY, Geng X, Li X, Peng C, et.al. Enhanced apoptosis from early physical exercise rehabilitation following ischemic stroke. J Neurosci Res 2017;95(4):1017-1024. [DOI:10.1002/jnr.23890]
23. Xing Y, Yang SD, Dong F, Wang MM, Feng YS, Zhang F. The beneficial role of early exercise training following stroke and possible mechanisms.Life Sciences 2018; 198: 32-37. [DOI:10.1016/j.lfs.2018.02.018]
24. Bell JA, Wolke ML, Ortez RC, Jones TA, Kerr AL. Training intensity affects motor rehabilitation efficacy following unilateral ischemic insult of the sensorimotor cortex in C57BL/6 mice. Neurorehabil Neural Repair 2015;29(6):590-8. [DOI:10.1177/1545968314553031]
25. Sun J, Ke Z, Yip SP, Hu XL, Zheng XX, Tong KY. Gradually increased training intensity benefits rehabilitation outcome after stroke by BDNF upregulation and stress suppression. Biomed Res Int 2014;2014:925762. [DOI:10.1155/2014/925762]
26. Willey JZ, Moon YP, Paik MC, Boden-Albala B, Sacco RL, Elkind MSV. Physical activity and risk of ischemic stroke in the Northern Manhattan Study. Neurology 2009;73(21):1774-9. [DOI:10.1212/WNL.0b013e3181c34b58]
27. Yelnik AP , Quintaine V, Andriantsifanetra C, Wannepain M, Reiner P, Marnef H,et.al. AMOBES (Active Mobility Very Early After Stroke): a randomized controlled trial. Stroke 2017;48(2):400-405. [DOI:10.1161/STROKEAHA.116.014803]
28. Pin-Barre C, Constans A, Brisswalter J, Pellegrino C, Laurin J. Effects of highversus moderateintensity training on neuroplasticity and functional recovery after focal ischemia. Stroke2017 ;48 (10):2855-2864. [DOI:10.1161/STROKEAHA.117.017962]
29. Wang Q, Wang PP, Meng PP, Han C, Yue SW. Intensive training accelerates the recovery of motor functions following cerebral ischemiareperfusion in MCAO rats. Eur Rev Med Pharmacol Sci 2016 ;20 (18) :3839-3852.
30. Dromerick AW, Lang CE, Birkenmeier RL, Wagner JM, Miller JP, Videen TO et.al. Very Early Constraint-Induced Movement during Stroke Rehabilitation (VECTORS): a single-center RCT. Neurology 2009;73(3):195-201. [DOI:10.1212/WNL.0b013e3181ab2b27]
31. Deplanque D, Masse I, Libersa C, Leys D, Bordet R. Previous leisure-time physical activity dose dependently decreases ischemic stroke severity. Stroke Res Treat 2012;2012:614925. [DOI:10.1155/2012/614925]
32. Lee SU, Kim DY, Park SH, Choi DH, Park HW, Han TR. Mild to moderate early exercise promotes recovery from cerebral ischemia in rats. Can J Neurol Sci 2009;36(4):443-9. [DOI:10.1017/S0317167100007769]
33. Zhang A, Bai Y, Hu Y, Zhang F, Wu Y, Wang Y, et.al. He. The effects of exercise intensity on p-NR2B expression in cerebral ischemic rats. Can J Neurol Sci 2012;39(5):613-8. [DOI:10.1017/S0317167100015341]
34. Shih EC, Yang YR, Wang RY. Effects of exercise intensity on spatial memory performance and hippocampal synaptic plasticity in transient brain ischemic rats. PLoS One 2013;8(10): e78163. [DOI:10.1371/journal.pone.0078163]
35. Stinear CM, Petoe MA, Anwar S, Barber PA, Byblow WD. Bilateral priming accelerates recovery of upper limb function after stroke: a randomized controlled trial. Stroke 2014;45(1):205-10. [DOI:10.1161/STROKEAHA.113.003537]
36. Silver KH, Macko RF, Forrester LW, Goldberg AP, Smith GV. Effects of aerobic treadmill training on gait velocity, cadence, and gait symmetry in chronic hemiparetic stroke: a preliminary report. Neurorehabil Neural Repair 2000;14(1):65-71. [DOI:10.1177/154596830001400108]
37. Linder SM, Rosenfeldt AB, Rasanow M, Alberts JL. Forced aerobic exercise enhances motor recovery after stroke: a case report. Am J Occup Ther 2015;69(4):1-8. [DOI:10.5014/ajot.2015.015636]
38. Platz T, vanKaick S, Mehrholz J, Leidner O, Eickhof C, Pohl M. Best conventional therapy versus modular impairment-oriented training for arm paresis after stroke: a single-blind, multicenter randomized controlled trial. Neurorehabil Neural Repair 2009;23(7):706-16. [DOI:10.1177/1545968309335974]
39. Ke Z, Yip SP, Li L, Zheng XX, Tam WK, Tong KY. The effects of voluntary, involuntary, and forced exercises on motor recovery in a stroke rat model. Annu Int Conf IEEE Eng Med Biol Soc 2011. PMID: 22256251
40. Guzik A, Drużbicki M , Wolan-Nieroda A. Assessment of two gait training models: conventional physical therapy and treadmill exercise, in terms of their effectiveness after stroke. Hippokratia 2018;22(2):51-59.
41. Luft AR, Macko RF, Forrester LW, Villagra F, Ivey F, Sorkin JD.Treadmill exercise activates subcortical neural networks and improves walking after stroke: a randomized controlled trial. Stroke 2008;39 (12):3341-50. [DOI:10.1161/STROKEAHA.108.527531]
42. Xiao X , Huang D, O'Young B. Gait improvement after treadmill training in ischemic stroke survivors: A critical review of functional MRI studies. Neural Regen Res 2012;7(31):2457-64.
43. Tally Z, Boetefuer L, Kauk C, Perez G, Schrand L, Hoder J. The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review. Top Stroke Rehabil 2017;24(7):539-546. [DOI:10.1080/10749357.2017.1345445]
44. Duncan PW, Sullivan KJ, Behrman AL, Azen SP, Wu SS, Nadeau SE, et. al. Body-weight-supported treadmill rehabilitation after stroke. N Engl J Med 2011;364(21):2026-36. [DOI:10.1056/NEJMoa1010790]
45. Mehrholz J, Pohl M, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev 2014;2014(1):CD002840. [DOI:10.1002/14651858.CD002840.pub3]
46. Mao YR, Lo WL, Lin Q , Li L, Xiao X, Raghavan P, et.al. The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke. Biomed Res Int 2015;2015:175719. [DOI:10.1155/2015/175719]
47. Laufer Y , Dickstein R, Chefez Y, Marcovitz E. The effect of treadmill training on the ambulation of stroke survivors in the early stages of rehabilitation: a randomized study. J Rehabil Res Dev 2001;38 (1):69-78.
48. Graham SA, Roth EJ , Brown DA. Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing bodyweight-supported treadmill training with versus without challenging mobility skills. J Neuroeng Rehabil 2018;15(1):92. [DOI:10.1186/s12984-018-0442-3]
49. Mehrholz J, Thomas S, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev 2017;8(8). [DOI:10.1002/14651858.CD002840.pub4]
50. Burnfield JM, Buster TW, Goldman AJ, Corbridge LM, Harper-Hanigan K. Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation. Hum Mov Sci 2016;47:16-28. [DOI:10.1016/j.humov.2016.01.012]
51. Hakakzadeh A, Shariat A, Honarpishe R, Moradi V, Ghannadi S, Sangelaji B. Concurrent impact of bilateral multiple joint functional electrical stimulation and treadmill walking on gait and spasticity in post-stroke survivors: a pilot study. Physiother Theory Pract 2021;37(12):1368- 1376. [DOI:10.1080/09593985.2019.1685035]
52. Al-Jarrah M, Shaheen S, Harries N, Kissani N, Molteni F, Bar Haim S , et.al. Individualized treadmill and strength training for chronic stroke rehabilitation: effects of imbalance. Top Stroke Rehabil 2014; 21(Suppl 1):25-32. [DOI:10.1310/tsr21S1-S25]
53. Roerdink M, Lamoth C JC, Kwakkel G, van Wieringen P CW, Beek PJ Gait coordination after stroke: benefits of acoustically paced treadmill walking. Phys Ther 2007;87(8):1009-22. [DOI:10.2522/ptj.20050394]
54. Lee SY, Im SH, Kim BR, Han EY. The Effects of a Motorized Aquatic Treadmill Exercise Program on Muscle Strength, Cardiorespiratory Fitness, and Clinical Function in Subacute Stroke Patients: A Randomized Controlled Pilot Trial. Am J Phys Med Rehabil 2018;97(8):533-540. [DOI:10.1097/PHM.0000000000000920]
55. In T , Jin Y, Jung K, Cho HY. Treadmill training with Thera-Band improves motor function, gait and balance in stroke patients. NeuroRehabilitation 2017;40(1):109-114. [DOI:10.3233/NRE-161395]
56. Bang YS, Hyun Son K, Kim HJ. Effects of virtual reality training using Nintendo Wii and treadmill walking exercise on balance and walking for stroke patients. J Phys Ther Sci 2016;28(11):3112-3115. [DOI:10.1589/jpts.28.3112]
57. Drużbicki M, Przysada G, Guzik A , Kwolek A, Brzozowska-Magoń A, Sobolewski M. Evaluation of the impact of exercise of gait on a treadmill on balance of people who suffered from cerebral stroke. Acta Bioeng Biomech 2016;18(4):41-48.
58. Hong M, Kim M, Kim TW, Park SS, Kim MK, Park YH, et.al. Treadmill Exercise Improves Motor Function and Short-term Memory by Enhancing Synaptic Plasticity and Neurogenesis in Photothrombotic Stroke Mice. Int Neurourol J 2020;24(Suppl 1):28-38. [DOI:10.5213/inj.2040158.079]
59. Phongamwong C, Rowe P, Chase K, Kerr A, Millar L. Treadmill training augmented with real-time visualisation feedback and function electrical stimulation for gait rehabilitation after stroke: a feasibility study. BMC Biomed Eng 2019;1:20. [DOI:10.1186/s42490-019-0020-1]
60. Yong MS, Kim SG, Cheon SH. Effects of skilled reach training with affected forelimb and treadmill exercise on the expression of neurotrophic factor following ischemia-induced brain injury in rats. J Phys Ther Sci 2017;29(4):647-650. [DOI:10.1589/jpts.29.647]
61. Zhang YX, Yuan MZ, Cheng L, Lin LZ, Du HW, Chen RH. Treadmill exercise enhances therapeutic potency of transplanted bone mesenchymal stem cells in cerebral ischemic rats via anti-apoptotic effects. BMC Neurosci 2015;5;16:56. [DOI:10.1186/s12868-015-0196-9]
62. Lee MH, Kim H, Kim SS, Lee TH, Lim BV, Chang HK, et.al. Treadmill exercise suppresses ischemia-induced increment in apoptosis and cell proliferation in hippocampal dentate gyrus of gerbils. Life Sci 2003;73(19):2455-65. [DOI:10.1016/S0024-3205(03)00655-6]
63. He Z, Wang X, Wu Y, Jia J, Hu Y, Yang X , et.al. Treadmill pre-training ameliorates brain edema in ischemic stroke via down-regulation of aquaporin-4: an MRI study in rats. PLoS One 2014;9(1). [DOI:10.1371/journal.pone.0084602]
64. Zhang Y, Cao RY, Jia X, Li Q, Qiao L, Yan G, et.al. Treadmill exercise promotes neuroprotection against cerebral ischemia-reperfusion injury via downregulation of pro-inflammatory mediators. Neuropsychiatr Dis Treat 2016;12:3161-3173. [DOI:10.2147/NDT.S121779]
65. Kang KA, Seong H, Jin HB, Park J, Lee J, Jeon JY, et.al. The effect of treadmill exercise on ischemic neuronal injury in the stroke animal model: potentiation of cerebral vascular integrity. J Korean Acad Nurs 2011;41(2):197-203. [DOI:10.4040/jkan.2011.41.2.197]
66. Bayod S, Del Valle J, Canudas AM, Lalanza JF, Sanchez-Roige S, Camins A, et.al. Long-term treadmill exercise induces neuroprotective molecular changes in rat brain. J Appl Physiol 2011;111(5):1380-90. [DOI:10.1152/japplphysiol.00425.2011]
67. Stoller O, deBruin ED, Schuster-Amft C, Schindelholz M, de Bie RA, Hunt KJ. Cardiovascular rehabilitation soon after stroke using feedback-controlled roboticsassisted treadmill exercise: study protocol of a randomised controlled pilot trial. Trials 2013;14:304. [DOI:10.1186/1745-6215-14-304]
68. Stoller O, de Bruin ED, Schindelholz M, SchusterAmft C, de Bie RA, Hunt KJ. Efficacy of FeedbackControlled Robotics-Assisted Treadmill Exercise to Improve Cardiovascular Fitness Early After Stroke: A Randomized Controlled Pilot Trial. J Neurol Phys Ther 2015;39(3):156-65. [DOI:10.1097/NPT.0000000000000095]
69. Macko RF, DeSouza CA, Tretter LD, Silver KH, Smith GV, Anderson PA , et.al. Treadmill aerobic exercise training reduces the energy expenditure and cardiovascular demands of hemiparetic gait in chronic stroke patients. A preliminary report. Stroke 1997;28(2):326-30. [DOI:10.1161/01.STR.28.2.326]
70. Macko RF, Katzel LI, Yataco A, Tretter LD, DeSouza CA, Dengel DR, et.al. Low-velocity graded treadmill stress testing in hemiparetic stroke patients. Stroke 1997;28(5):988-92. [DOI:10.1161/01.STR.28.5.988]
71. Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW. Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial. Neurorehabil Neural Repair 2012;26(1):85-95. [DOI:10.1177/1545968311418675]
72. Macko RF, Ivey FM, Forrester LW, Hanley D, Sorkin JD, Katze LI, et.al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke 2005;36(10):2206-11. [DOI:10.1161/01.STR.0000181076.91805.89]
73. Han EY, Im SH. Effects of a 6-Week Aquatic Treadmill Exercise Program on Cardiorespiratory Fitness and Walking Endurance in Subacute Stroke Patients: A PILOT TRIAL. J Cardiopulm Rehabil Prev 2018;38(5):314-319. [DOI:10.1097/HCR.0000000000000243]
74. Yoo J, Lim KB, Lee HJ, Kwon YG. Cardiovascularresponse during submaximal underwater treadmill exercise in stroke patients. Ann Rehabil Med 2014;38(5):628-36. [DOI:10.5535/arm.2014.38.5.628]
75. Sun H, Li A, Hou T, Tao X , Chen M, Wu C , et.al. Neurogenesis promoted by the CD200/CD200R signaling pathway following treadmill exercise enhances post-stroke functional recovery in rats. Brain Behav Immun 2019 ;82:354-371. [DOI:10.1016/j.bbi.2019.09.005]
76. Strømmen AM, Christensen T, Jensen K.Intensive treadmill training in the acute phase after ischemic stroke. Int J Rehabil Re 2016;39(2):145-52. [DOI:10.1097/MRR.0000000000000158]
77. Smith PS, Thompson M. Treadmill training post stroke: are there any secondary benefits? A pilot study. Clin Rehabil 2008;22(10-11):997-1002. [DOI:10.1177/0269215508088988]
78. Xu Y, Yao Y, Lyu H, Ng S, Xu Y, Poon WS , et.al. Rehabilitation Effects of Fatigue-Controlled Treadmill Training After Stroke: A Rat Model Study. Front Bioeng Biotechnol 2020;8:590013. [DOI:10.3389/fbioe.2020.590013]
79. Macko RF, Smith GV, Dobrovolny CL, Sorkin JD, Goldberg AP, Silver KH. Treadmill training improves fitness reserve in chronic stroke patients. Arch Phys Med Rehabil 2001;82(7):879-84. [DOI:10.1053/apmr.2001.23853]
80. Pang Q, Zhang H, Chen Z, Wu Y, Bai M, Liu Y, et.al. Role of caveolin-1/vascular endothelial growth factor pathway in basic fibroblast growth factor-induced angiogenesis and neurogenesis after treadmill training following focal cerebral ischemia in rats. Brain Res 2017;1663:9-19. [DOI:10.1016/j.brainres.2017.03.012]
81. Munari D, Pedrinolla A, Smania N, Picelli A, Gandolfi M, Saltuari L , et.al. High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial. Eur J Phys Rehabil Med 2018;54(3):408-418. [DOI:10.23736/S1973-9087.16.04224-6]
82. Brauer SG, Kuys SS, Paratz JD, Ada L. High-intensity treadmill training and self-management for stroke patients undergoing rehabilitation: a feasibility study. Pilot Feasibility Stud 2021;7(1):215. [DOI:10.1186/s40814-021-00941-w]

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