Journal of Neurologic Physical Therapy最新文献

{"title":"Factorial Validity of the 32-Item World Health Organization Disability Assessment Schedule 2.0 in Persons With Stroke.","authors":"Hsin-Yu Chiang, Yi-Ching Wang, Shih-Chieh Lee, Gong Hong Lin, Sheau-Ling Huang, Wen-Chou Chi, Chih-Wen Twu, Ching-Lin Hsieh","doi":"10.1097/NPT.0000000000000536","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000536","url":null,"abstract":"<p><strong>Background and purpose: </strong>The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a well-established tool for assessing disability. However, diverse factor structures complicate its interpretation, necessitating further validation. This study examined the factorial validity of the 32-item WHODAS 2.0 in persons with stroke using 1-factor, 6-factor, and 2-level hierarchical structures.</p><p><strong>Methods: </strong>A cross-sectional design was used with data from 1343 persons with stroke in the Taiwan Databank of Persons with Disabilities. Confirmatory factor analysis (CFA) was used to determine the valid structure of the 32-item WHODAS 2.0.</p><p><strong>Results: </strong>The 1-factor structure exhibited poor model fits, while the 6-factor and the overall 2-level hierarchical structure had acceptable model fits. However, the relationships between domains and overall score of the 2-level structure yielded poor fits. Excellent internal consistencies (Cronbach's α ≥ 0.90) were obtained for the 6 domain scores and the overall score.</p><p><strong>Discussion and conclusions: </strong>Our results revealed poor model fit for the 1-factor model, whereas the 6-factor structure and the overall 2-level hierarchical structure were both acceptable. However, the relationships between domains and the overall score within the 2-level structure were poor. The 6-factor model is preferable due to its better fit and alignment with WHODAS 2.0's design to assess multiple life perspectives. The 6-domain structure appears the most robust for persons with stroke. Thus, the 6 domain scores of the 32-item WHODAS 2.0 are recommended.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Capacity for Knowledge Translation in Rehabilitation: The Academy of Neurologic Physical Therapy's Knowledge Translation Summit.","authors":"Jennifer L Moore, Wendy M Romney, Beth Crowner, T George Hornby, Ian D Graham","doi":"10.1097/NPT.0000000000000533","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000533","url":null,"abstract":"<p><strong>Background and purpose: </strong>Enhancing health care through the implementation of evidence-based practices is a complex task, demanding specialized expertise and a distinct set of skills to facilitate success. A knowledge translation (KT) capacity-building initiative is a process that leads to greater individual, organizational, or system capabilities to translate high-quality evidence, such as clinical practice guidelines, into practice. The KT Summit, a KT capacity-building initiative, was developed by the Academy of Neurologic Physical Therapy and includes an in-person workshop, quarterly reports, mentoring for 2 years, and a funding opportunity. The purpose of this manuscript is to describe the development, implementation, and outcomes of the KT Summit over a 6-year period.</p><p><strong>Summary of key points: </strong>In this special interest article, we describe the KT Summit's development and evolution, application process, education and training format, curriculum, funding opportunity, outcomes, and lessons learned. Over the initial 3 cohorts, there was a notable increase in the number of projects initiated and groups. Furthermore, there was a substantial decline in the failure rate of projects, decreasing from 50% to 15% over time. This article outlines the reported contributors to success and the ways the participants used their KT education.</p><p><strong>Recommendations for clinical practice: </strong>This article highlights an education and training method that resulted in successful implementation initiatives across several health care organizations. Factors that contributed to KT success included participating in the KT Summit, support from organizational leadership, and a local champion. More research is needed to evaluate the optimal components and economic outcomes of KT capacity-building initiatives.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Trans-spinal Direct Current Stimulation on Gait Function in People With Multiple Sclerosis.","authors":"Gülser Cinbaz, Zübeyir Sarı, Semra Oğuz, Lütfü Hanoğlu, Juan Jose Fernández-Pérez, Julio Gómez-Soriano","doi":"10.1097/NPT.0000000000000534","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000534","url":null,"abstract":"<p><strong>Background and purpose: </strong>Multiple sclerosis (MS) presents significant challenges due to its inflammatory and degenerative nature, often manifesting in debilitating symptoms such as gait disturbances. Non-invasive stimulation techniques, such as trans-spinal direct current stimulation (tsDCS), offer promising avenues for enhancing functional recovery, but evidence on tsDCS effectiveness in neurological disorders remains sparse. This study aimed to investigate the effects of cathodal tsDCS on gait function and fatigue in people with MS (pwMS) compared to sham tsDCS.</p><p><strong>Methods: </strong>Twenty-two pwMS received 6 sessions of 20-minute cathodal tsDCS (n = 11) or sham tsDCS (n = 11) in addition to a physiotherapy program. The primary outcomes were the Timed 25-Foot Walk (T25-FW), Timed Up and Go test (TUG), gait speed, and the Multiple Sclerosis Walking Scale-12 (MSWS-12) evaluated before and after treatment. The secondary outcome was fatigue, measured with the Fatigue Severity Scale (FSS) and Fatigue Impact Scale (FIS).</p><p><strong>Results: </strong>Intergroup comparisons showed a significant improvement in the cathodal tsDCS group compared to the sham tsDCS group. Specifically, there was a greater reduction in pre-post values for T25-FW (Median: -4.43; Range: -12.1 to -1.0), MSWS-12 (-16.70; -31.7 to -5.0), TUG (-6.03; -20.8 to -0.7), FSS (-0.30; -2.2 to 0.1), and FIS-Physical (4.00; -13.0 to 0.0). Additionally, walking speed increased significantly (0.15; 0.02 to 0.24) in the cathodal tsDCS group. Moreover, all gait-related outcomes and FSS showed large effect sizes (r > 0.5), indicating a strong intervention effect.</p><p><strong>Discussion and conclusions: </strong>Incorporating cathodal tsDCS into a physiotherapy program improved walking function and fatigue in pwMS. Although replication is warranted, these results hold promise for clinical applications, highlighting tsDCS as a potential tool for enhancing motor function and reducing fatigue in pwMS.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see Supplemental Digital Content available at http://links.lww.com/JNPT/A542).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Walking Capacity Outcomes After Moderate-to-High Intensity Locomotor Training in Chronic Stroke.","authors":"Christina Garrity, Darcy S Reisman, Sandra A Billinger, Katie A Butera, Pierce Boyne","doi":"10.1097/NPT.0000000000000528","DOIUrl":"10.1097/NPT.0000000000000528","url":null,"abstract":"<p><strong>Purpose: </strong>Moderate-to-high intensity locomotor training (M-HIT) is strongly recommended in stroke rehabilitation, but outcomes are variable. This study aimed to identify baseline clinical characteristics that predict changes in walking capacity following M-HIT in chronic stroke.</p><p><strong>Methods: </strong>This analysis used data from the HIT-Stroke Trial (N = 55), which involved up to 36 sessions of either moderate- or high-intensity locomotor training. A prespecified model assessed how well baseline motor impairment (Fugl-Meyer lower limb motor scale [FM-LL]), comfortable gait speed (CGS), and balance confidence (Activities-specific balance confidence scale [ABC]) independently explain changes in 6-minute walk distance (∆6MWD), while controlling for the treatment group. Exploratory analysis tested additional baseline covariates using the all-possible regressions procedure. The predictive value of each potential covariate was assessed by its average contribution to the explained variance in ∆6MWD (∆pseudo-R2).</p><p><strong>Results: </strong>With the prespecified model, 8-week ∆6MWD was significantly associated with baseline FM-LL (β = 5.0 [95% CI: 1.4, 8.6]) and ABC (β = 0.7 [0.0, 1.4]), but not CGS (β = - 44.6 [-104.7, 15.6]). The exploratory analysis revealed that the top 7 covariates with the highest mean ∆pseudo-R2 were FM-LL, pain-limited walking duration, ABC, the use of an assistive device, fatigue, depression, and recent walking exercise history >2 days per week.</p><p><strong>Discussion and conclusions: </strong>On average, participants with less motor impairment and higher balance confidence exhibit greater walking capacity improvements after M-HIT in chronic stroke. Additional negative predictive factors may include pain-limited walking duration, use of an assistive device, fatigue, depression, and recent walking exercise; however, these exploratory findings need to be confirmed in future studies.</p><p><strong>Video abstract: </strong>Supplemental Digital Content available at [http://links.lww.com/JNPT/A533].</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Perceptions of Important Knowledge, Skills, and Abilities for Entry-Level Vestibular Physical Therapy.","authors":"Andrew E Littmann, Holly J Roberts, Diane M Wrisley, Lisa L Heusel-Gillig, Charles M Plishka, Anne K Galgon","doi":"10.1097/NPT.0000000000000531","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000531","url":null,"abstract":"<p><strong>Background and purpose: </strong>No clear consensus exists regarding the expected proficiency of entry-level physical therapists (PTs) when practicing vestibular physical therapy (VPT). The aims of this research were to: 1) ascertain clinicians' and administrators' expectations of entry-level PTs' knowledge, skills, and abilities (KSA) for practicing VPT, and 2) explore correlations between clinician characteristics and their expectations for VPT KSA and performance level for entry-level PTs.</p><p><strong>Methods: </strong>PTs and PT managers in the United States were invited to complete a survey consisting of 3 parts: 1) clinician/entity demographics, 2) importance of knowledge in foundational sciences, diagnostic groups, examination and intervention skills, and clinical decision-making, and 3) level of expected clinical performance. Rating frequencies and Spearman correlation coefficients between respondent characteristics and survey responses were calculated. Clinical expertise was dichotomized and differences between ratings were compared with the Mann-Whitney U test.</p><p><strong>Results: </strong>Four hundred fifty-eight respondents completed the survey, prioritizing KSAs of benign paroxysmal positional vertigo (70.0%), postconcussion dizziness (45.1%), and vestibular hypofunction (43.4%) as most important. Eighty-three percent of respondents expected competence for VPT at graduation as advanced beginner (26.7%), intermediate (33.6%), or advanced intermediate (22.4%). Relationships between respondent characteristics and survey responses were fair to poor. Experienced clinicians rated item importance higher than novices, but their expected competence levels did not differ.</p><p><strong>Discussion and conclusion: </strong>Differences were found between expert and novice clinicians regarding the importance of VPT KSA, but certain items were deemed important for entry-level practice. The findings lay the groundwork for the development of recommendations for entry-level VPT curriculum.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Flow Restriction Training in People With Parkinson Disease: A Mixed-Methods Feasibility Study.","authors":"Mark M Mañago, Lauren Van Valkenburgh, Katie Boncella, Robert Will, Jeanne Feuerstein, Laura A Swink, Cory L Christiansen","doi":"10.1097/NPT.0000000000000530","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000530","url":null,"abstract":"<p><strong>Background and purpose: </strong>To determine the feasibility of low-load resistance blood flow restriction training (BFRT) in people with Parkinson disease (PD).</p><p><strong>Methods: </strong>This prospective cohort, convergent parallel mixed-methods design investigated the feasibility of 8 weeks of low-load resistance BFRT in people with PD. Feasibility was determined by enrolling 20 participants, ≥80% retention and adherence, and no serious intervention-related adverse events. Semistructured interviews and questionnaires evaluated acceptability and satisfaction. Changes in muscle strength and thickness, mobility, physical activity, and patient-reported outcomes were also assessed.</p><p><strong>Results: </strong>Sixteen of 20 participants (80%) were retained at the postintervention assessment (68.1 ± 8.6 years old, 44% Female), completing 88% of visits with no serious adverse events. Qualitative analysis identified 3 themes: satisfaction and acceptability, functional capacity changes, and program feedback. Most participants were satisfied (88%), and lack of satisfaction was primarily related to pressure intolerance and exercise specificity. There were improvements in knee extension and ankle plantarflexion strength (18-22%), 30-Second Sit to Stand (+2.2 reps), Timed Up and Go (-2.1 seconds), and 10-Meter Walk Test (0.12 m/s). The average daily step count decreased (-476 steps/day) and sedentary time increased (21 minutes/day). There were minimal changes in elbow extension strength, rectus femoris muscle thickness, Parkinson's Fatigue Scale, and Patient-Specific Functional Scale.</p><p><strong>Discussion and conclusions: </strong>BFRT was feasible and safe in people with PD, with promising improvements in muscle strength and mobility, warranting a future efficacy study. Clinicians considering BFRT should carefully evaluate tolerance and make sure BFRT aligns with patient goals.</p><p><p>Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A539).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Loneliness in People With Parkinson Disease Participating in Community-based Exercise.","authors":"L A Swink, D Diprinzio, J Brown, D Novak, C L Christiansen, M M Mañago","doi":"10.1097/NPT.0000000000000532","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000532","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study determined the prevalence of loneliness in a regional community-based exercise class program for people with Parkinson disease (PwPD) and examined relationships with demographic characteristics, functional independence, functional mobility, and quality of life (QOL).</p><p><strong>Methods: </strong>This study was a cross-sectional analysis of 231 PwPD, all of whom were participating in community-based exercise class programs. Participants completed questionnaires on loneliness (UCLA 3-Item Loneliness Scale [UTILS]), functional independence (Schwab & England Scale), performance-based measures of functional mobility (Timed Up & Go, 10 Meter Walk Test, 30 Second Sit-to-Stand), and QOL (Parkinson's Disease Questionnaire-8). UTILS scores of ≤ 4 were classified as \"non-lonely,\" and scores > 4 were classified as \"lonely.\"</p><p><strong>Results: </strong>Participants were, on average, 71.9 (±7.5) years old, 5.4 (±5.4) years since their Parkinson disease diagnosis, had been participating in group exercise classes for 2.3 (±2.4) years, and almost one-third of participants (n = 76/231, 32.9%) scored in the \"lonely\" range on the UTILS. There were significant differences between the lonely and non-lonely groups in sex distribution, functional independence, Timed Up & Go, and QOL. Age, functional independence, and loneliness scores accounted for 55.8% of the variance in QOL scores.</p><p><strong>Discussion and conclusion: </strong>In this study, loneliness was present even in PwPD actively engaged with an exercise community. Loneliness among PwPD was also related to functional independence, functional mobility, and QOL. While further study is needed, having rehabilitation clinicians and exercise class instructors screen for loneliness in PwPD may help inform plans of care and recommendations to address loneliness.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and Functional Changes With 8 Weeks of Backward Walking Training in Multiple Sclerosis: A Case Series.","authors":"Maryam M Abbawi, Michael VanNostrand, Patrick G Monaghan, Taylor N Takla, Biaohua Yu, Ana M Daugherty, Jeffrey A Stanley, Nora E Fritz","doi":"10.1097/NPT.0000000000000529","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000529","url":null,"abstract":"<p><strong>Background and purpose: </strong>Individuals with multiple sclerosis (MS) experience mobility declines and an increased risk of falls. Studies in MS have suggested backward walking (BW) as a promising intervention to improve mobility, yet the impact of BW on reactive balance, physical activity, prospective falls, and brain structure has not been explored. The purpose of this case series was to examine feasibility, acceptability, and impact of 8 weeks of BW training (BWT) on gait speed, static and reactive balance, fall incidence, physical activity, and white matter microstructure. A secondary aim was to explore concurrent changes in structure and function with BWT.</p><p><strong>Case description: </strong>Eight ambulatory individuals with relapsing-remitting MS performed forward walking (FW) and BW, static and reactive balance tests, and underwent myelin water imaging (MWI) pre- (baseline) and post-intervention. MWI metrics were extracted from the body of the corpus callosum, superior cerebellar peduncle, and corticospinal tract. Physical activity was measured for 1 week before and after the intervention, and falls were monitored prospectively for 6 months.</p><p><strong>Intervention: </strong>Eight weeks of laboratory (1×/week) and home-based (2×/week) BWT; in the laboratory, individuals performed treadmill and overground BW followed by functional exercises incorporating backward stepping. At home, participants performed overground BW and the same functional exercises.</p><p><strong>Outcomes: </strong>BWT was feasible (100%) and acceptable (96.9%). All participants exhibited increased microstructural changes on the MWI metrics in at least 1 region of interest. Participants demonstrated decreases in sway area during static balance tasks (7/8), decreases in postural latency during reactive stepping (7/8), increases in BW velocity (6/8), and increases in FW velocity (4/8). There was a decrease in fall rate from baseline to 6 months post-intervention (4/7).</p><p><strong>Discussion: </strong>Eight weeks of BWT resulted in structural and functional changes; however, a larger sample size is needed to determine the clinical significance and generalizability of these findings.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A536.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching Significance: Statistical Guidance for Authors and Reviewers.","authors":"Keith R Lohse, Stephanie Kliethermes","doi":"10.1097/NPT.0000000000000526","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000526","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Individual Factors on Exercise Dose During a Walking Intervention in People With Stroke.","authors":"Kiersten M McCartney, Ryan T Pohlig, Duncan Thibodeau Tulimieri, Pierce Boyne, Susanne M Morton, Darcy S Reisman","doi":"10.1097/NPT.0000000000000517","DOIUrl":"10.1097/NPT.0000000000000517","url":null,"abstract":"<p><strong>Background and objective: </strong>There has been a substantial increase in the number of studies demonstrating improvements in walking capacity in people with chronic stroke following moderate-to-high intensity walking exercise interventions. Yet, there is significant variability in response to these interventions. This is likely due to the heterogeneity in this population and the variability in the exercise dose parameters actually attained within these walking interventions. Exercise prescription can be optimized by understanding how individual variables impact walking exercise dose. This study leveraged a large, clinical dataset to classify people with chronic stroke into homogeneous groups (called classes) and compare classes on the walking exercise dose achieved in a walking intervention.</p><p><strong>Methods: </strong>One hundred sixty-nine people with chronic (>6-Months) stroke completed clinical evaluations and a 12-week high-intensity treadmill intervention. Baseline measures of walking capacity, physical health, and psychosocial factors were used in a latent variable mixture model to assess if latent, homogeneous classes existed within the dataset. Objective criteria determined the optimal number of classes, which were compared to the walking exercise dose attained across the intervention.</p><p><strong>Results: </strong>Four homogeneous classes were distinguished by differences in baseline walking capacity, steps-per-day, comorbidity burden, and balance self-efficacy. Despite clear \"clinical profiles\" of people with chronic stroke, these classes did not differ on the walking exercise dose attained.</p><p><strong>Discussion and conclusions: </strong>Prior literature and clinical intuition suggest individuals with lower baseline walking capacity, physical health, and self-efficacy are less likely to tolerate high-intensity exercise, however our results demonstrate this is not true for people with chronic stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A524 .</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"153-161"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}