Neuro Navigators Episode 27: High-Intensity Gait Training: Is It More Than Just Walking?

Join Dr. Annie Tapp, PT, DPT, PhD, NCS, an expert in implementation science and neurologic rehabilitation, as she breaks down the active ingredients of effective gait interventions. Alongside host J.J. Mowder-Tinney, you’ll discover how to move beyond “just walking” by using a clinical reasoning framework to prioritize gait subcomponents like stance stability and limb advancement. Together, they explore practical strategies for maintaining high intensity without sacrificing biomechanical specificity. You will learn how to calibrate sessions in real time and embrace patient errors as essential drivers for neuroplasticity.

Learning Outcomes

• Analyze the evidence around high-intensity gait training and the motor learning principles that support its use
• Apply evidence-based, practical strategies to actionably address the biomechanical subcomponents of gait in individualized training sessions
• Solve patient case scenarios involving the design and progression of high-intensity subcomponent-targeted interventions for patients with stroke

Timestamps

• (00:00:00) Welcome
• (00:00:05) Introduction to high-intensity gait training
• (00:02:54) Challenges in understanding abnormal gait
• (00:04:48) Functional subcomponents of gait
• (00:07:41) Barriers to implementing high-intensity gait training
• (00:11:01) Alternative approaches to high-intensity training
• (00:14:36) Motor learning and individualized interventions
• (00:16:50) Addressing cognitive impairments in therapy
• (00:18:52) High-intensity training for nonambulatory patients
• (00:21:48) Creating engaging therapy sessions
• (00:24:05) Examining gait components in therapy
• (00:30:00) Motivating patients through progression
• (00:32:49) Documentation strategies for clinicians
• (00:35:00) Heart rate and RPE in therapy
• (00:39:18) Building patient buy-in
• (00:41:58) Key takeaways for clinicians
• (00:42:58) Case study: outpatient stroke rehabilitation
• (00:48:38) Case study: inpatient stroke rehabilitation

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