4.22 Walking

Approximately half of people with stroke are unable or are limited in their ability to walk. Although most regain some mobility, few regain their previous level. Impaired speed, endurance and energy efficiency often limit activity and participation even in those who are independently mobile. Unsurprisingly, walking is a high priority for many people after a stroke and enables increased independence in functional tasks and participation. This section focuses on treatments and equipment to improve walking, the basis of which should be intensive practice of walking and exercise using aids and equipment as necessary to enable safe practice and mobility during usual activities (such as treadmills, electro-mechanical gait trainers, activity and heart rate monitors). Walking practice at a level that promotes cardiovascular training builds motor skills, strength and cardiovascular fitness which enables greater activity in everyday life. Real-world walking is an important aspect of rehabilitation and is often a goal identified by people with stroke who need to traverse uneven ground, walk dogs or manage inclines. [2023]