Maintaining gains after intervention ceases remains the holy grail of stroke rehabilitation. Clinical trials of community-dwelling people after stroke repeatedly demonstrate immediate benefits, which subsequently decrease once intervention ceases. Future research needs to focus on how stroke survivors with walking speeds > 0.4 m/s can become life-long exercisers

and maintain a reasonable level of physical activity. The challenge is to develop appropriate, accessible, low-cost, community exercise programs that individuals after stroke who have reasonable walking speed are encouraged to attend on an ongoing basis. Future research needs to concentrate PI3K inhibitor on implementation and ways of overcoming the barriers to life-long exercise after check details stroke and testing strategies for promoting

life-long adherence to exercise programs. In conclusion, the results of this study demonstrate a differential effect of a treadmill and overground walking intervention based on initial walking speed. The additional benefit of the treadmill and overground walking intervention in walking distance and speed was greater for those who walked faster at the start of therapy. However, the additional benefit declined over time. What is already known on this topic: Despite regaining the ability to walk, many survivors of stroke do not regain their original walking speed or distance, which affects participation in the community. Overall, treadmill training has moderately beneficial effects on walking speed and distance in stroke survivors. However, the variability in these outcomes suggests that different groups of stroke survivors may differ in their response to treadmill training. What this study adds: Treadmill training typically provides greater benefits in walking speed and distance in stroke survivors whose comfortable walking speed before training is over 0.4 m/s. Clinicians should use comfortable walking speed to predict the potential for improvement with treadmill training. Ethics approval: Sydney University Human Research Ethics Committee (02–2007/9665)

Cell press approved this study. All participants gave informed consent before data collection began. Competing interests: Nil Source(s) of support: The Heart Foundation of Australia and The University of Sydney supported this study. Acknowledgements: The authors would like to acknowledge the significant contribution in coordination and training during the AMBULATE trial by Gemma Lloyd, Wendy Robinson and Janine Vargas. Correspondence: Catherine Dean, Head of Department of Health Professions, Macquarie University, Australia. Email: [email protected] “
“Activities of childhood and adolescence, such as vigorous physical activity, computer use and playing musical instruments, contribute to physical, cognitive and social development.