Low intensity strength training for ambulatory stroke patients

Purpose. To investigate feasibility and effectiveness of an individually-directed, group strength-training programme on knee muscle strength after stroke. Method. Ten volunteers ( 62 +/- 11 years, mean +/- SD), 6 - 12 months after first-ever unilateral stroke, walking independently with or without aids were recruited. Using an A1-B-A2 design, 3 sets of baseline measures were taken at 2 weekly intervals; volunteers then attended twice weekly sessions of low intensity progressive strengthening exercises and were assessed after each series of 8 sessions to a maximum of 24 sessions; post training, measures were repeated after 4 - 6 weeks. Measures included isometric and concentric knee extensor muscle strength and 10m walking velocity. Results. Strength of knee extensor muscles was improved after training ( ANOVA, p < 0.05). On cessation of training, isometric strength increased by 58 +/- 19% and concentric strength at 30 degrees/s by 51 +/- 14%; walking velocity quickened from 0.47 +/- 0.06m (.) s(-1) to 0.57 +/- 0.08m (.) s(-1) ( t = 3.31, p < 0.01). These gains were maintained 4 - 6 weeks after completion of training. Conclusions. These findings support the use of low intensity strength training after stroke and confirm published evidence. It was feasible for one therapist to deliver the training programmes for 4 - 6 participants at a time; an important feature when resources are limited.