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Intensity matters! In the fourth and final of a multi-part series on stroke, Dr. Michael Powers explores best current evidence in stroke interventions including task-oriented training, clinical practice guidelines to improve locomotor function, and clinical practice guidelines on the use of ankle foot orthoses and functional electrical stimulation. He highlights the importance of keeping intensity, salience, and repetitions high during stroke rehabilitation to drive neuroplasticity. He discusses the importance of emphasizing interventions at the participation and activity level, and how treatments which overly emphasize body function and structure are not consistent with the best current evidence nor the recommended approach to examination which was discussed last episode. He hopes that by the end of this episode you will start thinking of your patients as athletes who benefit from high intensity practice!

Key Takeaways

• Task-Oriented Training and Neuroplasticity
• Movement is at the intersection of the individual, the task, and the environment
• Key features to consider at the levels of the individual, the task, and the environment
• Improving Locomotor Function Clinical Practice Guideline
• Importance of high intensity in improving walking function
• Intensity, repetitions, and salience more important than normalizing gait kinematics
• Clinical Practice Guideline for Use of AFOs and FES Post Stroke
• AFOs and FES with multiple benefits across ICF domains

References

• O'Sullivan & Schmitz's Physical Rehabilitation, 8th ed.
• Shumway-Cook and Woollacott Motor Control, 6th ed.
• Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury
• Clinician Resources for Locomotor CPG
• A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke
• Clinician Resources for AFO and FES CPG

All music courtesy of Free Music Archive and used via attribution 4.0 international license.

• Intro and Outro: Stylin' by JMHBM
• Transitional: Our Reality by Ketsa

Connect

• email: neuropowerhour@drmichaelpowers.com
• LinkedIn