on April 22, 2004
Published online before print April 22, 2004, doi: 10.1161/01.STR.0000127785.73065.34
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Submitted on October 23, 2003
From the Human Physiology Laboratory (M.M.O., N.K.L., R.A.F.), Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Mass; Department of Physical Medicine and Rehabilitation (J.F.B., E.P., J.S., W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Mass; Hebrew Rehabilitation Center for Aged (J.F.B.), Boston, Mass. * To whom correspondence should be addressed. E-mail: fielding{at}bu.edu.
Background and Purpose--To evaluate the efficacy of supervised high-intensity progressive resistance training (PRT) on lower extremity strength, function, and disability in older, long-term stroke survivors. Methods--Forty-two volunteers aged 50 years and above, 6 months to 6 years after a single mild to moderate stroke, were randomized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press (LP), unilateral paretic and nonparetic knee extension (KE), ankle dorsiflexion (DF), and plantarflexion (PF) exercises. Functional performance was assessed using the 6-minute walk, stair-climb time, repeated chair-rise time, and habitual and maximal gait velocities. Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument (LLFDI). Results--Single-repetition maximum strength significantly improved in the PRT group for LP (16.2%), paretic KE (31.4%), and nonparetic KE (38.2%) with no change in the control group. Paretic ankle DF (66.7% versus -24.0%), paretic ankle PF (35.5% versus -20.3%), and nonparetic ankle PF (14.7% versus -13.8%) significantly improved in the PRT group compared with the control. The PRT group showed significant improvement in self-reported function and disability with no change in the control. There was no significant difference between groups for any performance-based measure of function. Conclusions--High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke, and results in reductions in functional limitations and disability.
Revised on December 16, 2003
Accepted on January 8, 2004
High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors
Michelle M. Ouellette MSPT;
Key words: exercise • cerebrovascular accident • rehabilitation • recovery of function
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