Rehabilitation Intensity and Frequency

For optimal recovery, it’s widely recommended that relearning to walk involves high-intensity, repetitive practice that stimulates the nervous system’s ability to “rewire” itself, a process called neuroplasticity. This often means engaging in physical therapy multiple times a week, sometimes for sessions lasting two or more hours. Consistency and repetition are crucial.

​Some key aspects of this training include:

• ​Body-weight support systems: A harness supports a portion of a person’s weight over a treadmill or on solid ground, allowing them to practice walking without the full burden of their body weight.

• ​Functional electrical stimulation (FES): Electrodes are placed on the skin to deliver electrical currents that stimulate weakened muscles, causing them to contract and helping to retrain the brain to activate those muscles.

• ​Robotic-assisted devices: Robotic exoskeletons can assist impaired limbs in performing repetitive walking motions.

• ​Overground training: This involves walking on solid ground with the assistance of a therapist, parallel bars, a walker, or other mobility aids.

​Recovery Timeline

​While every person’s recovery journey is unique, there are some general timelines observed in different conditions:

• ​Stroke: With proper rehabilitation, a significant number of stroke survivors (65% to 85%) are able to walk independently within six months. However, improvement can continue for years, especially with continued therapy.

• ​Spinal Cord Injury (SCI): The fastest and most significant recovery typically occurs within the first six months after the injury due to a heightened state of neuroplasticity. However, some individuals continue to make small improvements for up to one to two years or even longer. The extent of recovery depends heavily on the severity and location of the injury.

• ​Traumatic Brain Injury (TBI): The recovery timeline varies greatly. Some people show improvement within days or weeks, while others require months or even years of therapy. The most rapid progress is often seen in the period between three and twelve months after the injury. After six months, about 60% of TBI patients can walk again, and some continue to improve for up to 10 years post-injury.

​Factors Affecting Recovery

​Several factors influence a person’s ability to relearn how to walk and the timeline for recovery:

• ​Severity of the injury: Less severe injuries generally lead to faster and more complete recovery.

• ​Intensity and consistency of rehabilitation: Consistent, high-intensity therapy is a major predictor of successful outcomes.
• ​Pre-existing health conditions: An individual’s overall health before the injury can affect their recovery.

• ​Age: Younger individuals often heal and recover faster.

• ​Motivation and support: A strong support system and personal motivation are essential for a long and challenging rehabilitation journey.