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Table 1 Visual cue training (VCT): treatment progression

From: Visual cue training to improve walking and turning after stroke: a study protocol for a multi-centre, single blind randomised pilot trial

Progression

Treatment goal categories

treatment phase (sessions)

Walking speed target

Symmetry target

Turning ability target

Gait adaptability/ translation to functional mobility

Intensity

I (1–4)

Increasing walking speed in 10% increments, as tolerated, from baseline to the target threshold (either 0.4m/s or 0.8m/s depending on initial SSWS)

Improving symmetry of (a)step-length, (b) stance and swing phases in 10% increments, as tolerated

  

Four 5 min bouts of walking to total 20 min of stepping with each bout addressing one of the goals at a time

II (5–10)

Increasing walking speed in 10% increments, as tolerated, from baseline to the target threshold (either 0.4m/s or 0.8m/s depending on initial SSWS)

Improving symmetry of step-length, stance and swing phases in 10% increments, as tolerated, while maintaining new walking speed

10% improvement in turning towards ability to turn in two steps, 2 seconds in either direction while maintaining new walking speed

10% improvement in the number of failures to hit targets presented unpredictably in timing and location on both limbs while maintaining new walking speed

Increase bout duration and decrease number of bouts; however, each goal is still addressed individually in blocks of practice

III (11–16)

Practice at maintenance of walking speed over threshold and at altering speed as dictated by varying speed of presentation of footfall targets

Practice at maintenance of symmetrical stepping

Two steps, 2 seconds in either direction when turns are unpredictable

Able to alter stepping pattern to hit targets presented unpredictably in timing and location on either limb

20–30 min of sustained *good quality stepping

  1. *Good quality stepping is defined as walking with spatial symmetry of stepping pattern and dynamic trunk control during adaptations to step length and turning.
  2. Self selected walking speed SSWS.