Long-standing research in animal models and humans with stroke or incomplete spinal cord injury (iSCI) indicate that specific physical training variables, such as the specificity and amount of practice, may influence neurological recovery and locomotor function. More recent data highlight the contributions of exercise intensity, as estimated indirectly by cardiovascular exertion, as potentially more important than previously considered. The effects of exercise intensity are well described in neurologically intact individuals, although confusion regarding the definitions of intensity and safety concerns have limited its implementation during physical rehabilitation of patients with neurological injury. The purpose of this review is to delineate some of the evidence regarding the effects of exercise intensity during locomotor training in patients with stroke and iSCI. We provide specific definitions of exercise intensity used within the literature, describe methods used to ensure appropriate levels of exertion, and discuss potential adverse events and safety concerns during its application. Further details on the effects of locomotor training intensity on clinical outcomes, and on neuromuscular and cardiovascular function will be addressed as available. Existing literature across multiple studies and meta-analyses reveals that exercise training intensity is likely a major factor that can influence locomotor function following neurological injury. To extend these findings, we describe previous attempts to implement moderate to high intensity interventions during physical rehabilitation of patients with neurological injury, including the utility of specific strategies to facilitate implementation, and to navigate potential barriers that may arise during implementation efforts.

中文翻译：

---

特别交流：高强度运动训练在急性发作神经损伤患者中的应用价值

对患有中风或不完全脊髓损伤 (iSCI) 的动物模型和人类的长期研究表明，特定的身体训练变量，例如练习的特异性和数量，可能会影响神经恢复和运动功能。最近的数据强调了运动强度的贡献（通过心血管运动间接估计），可能比之前认为的更重要。运动强度的影响在神经系统完好的个体中得到了很好的描述，尽管运动强度的定义和安全问题的混淆限制了其在神经损伤患者身体康复过程中的实施。本综述的目的是描述关于中风和 iSCI 患者运动训练期间运动强度影响的一些证据。我们提供文献中使用的运动强度的具体定义，描述用于确保适当运动水平的方法，并讨论其应用过程中潜在的不良事件和安全问题。有关运动训练强度对临床结果以及神经肌肉和心血管功能影响的更多详细信息将在可用时予以讨论。多项研究和荟萃分析的现有文献表明，运动训练强度可能是影响神经损伤后运动功能的主要因素。为了扩展这些发现，