Key result
Achieving targeted heart rate reserves during locomotor training was not a primary determinant of changes in walking speeds or distances poststroke.
Why the study?
It was unclear whether slower walking speeds or beta-blocker use influence the ability to achieve targeted heart rates during locomotor training poststroke and affect subsequent locomotor outcomes.
Do patient-related variables like baseline walking speed and beta-blocker use influence the ability to achieve targeted heart rates during locomotor training, and does this affect locomotor outcomes in poststroke patients?
RCT (n=90)
Randomized
Do patient-related variables like baseline walking speed and beta-blocker use influence the ability to achieve targeted heart rates during locomotor training, and does this affect locomotor outcomes in poststroke patients?
Achieving targeted heart rate reserves during locomotor training poststroke is not a primary determinant of locomotor outcomes, and beta-blocker use blunts the ability to reach these targets.
Answers are grounded in this paper and cite their sources.
Targeted HR achievement does not determine locomotor gains poststroke; challenges HR-centric protocols and supports RPE monitoring in β-blocker users.
BACKGROUND AND PURPOSE: Previous studies suggest targeting higher heart rates (HRs) during locomotor training improves locomotor outcomes (ie, walking speed and distances) in individuals poststroke. However, those who walk slower or are prescribed β-adrenergic antagonists (β-blockers) may not achieve targeted HRs. The purpose of this study was to evaluate the contributions of these patient-related variables on the ability to achieve targeted HRs during graded exercise testing (GXT) or locomotor training, and their effects on locomotor outcomes. METHODS: This secondary analysis of a randomized trial enrolled 90 individuals >6 months poststroke assigned to either high-intensity training targeting >70% HR reserve (HRR) or low-intensity training (<40% HRR). Associations between baseline walking speeds and distances or β-blocker use versus HRRs during GXTs and training were identified. Subsequent analysis focused on whether training HRs or ratings of perceived exertion (RPEs) were related to changes in walking speeds/distances. RESULTS: Achieving higher HRRs during GXTs was related to faster peak treadmill speeds (r = 0.60, P < 0.01) and β-blockers use (r = -0.23, P < 0.05). However, training HRRs were unrelated to initial locomotor outcomes, with depressed HRRs in those using β-blockers. Only 40% of participants averaged >70% HRRs during high-intensity training. Regression analysis suggested training HRRs were related to walking speeds/distances only in those without β-blockers, while RPEs were correlated regardless of β-blocker use. Analysis of changes in walking speeds/distances indicates no differences in those able or unable to achieve targeted HRRs. DISCUSSION AND CONCLUSION: Achieving targeted HRRs was not a primary determinant of locomotor outcomes, although attempts to achieve higher intensities and use of RPEs may be helpful.
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Hornby et al. (2026) conducted an RCT in Poststroke (n=90). High-intensity locomotor training targeting >70% HR reserve vs. Low-intensity training (<40% HR reserve) was evaluated on Changes in walking speeds and distances. Achieving targeted heart rate reserves during locomotor training was not a primary determinant of changes in walking speeds or distances poststroke.
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