Progressive resistance training after stroke: Effects on muscle strength, muscle tone, gait performance and perceived participation

Objective: To evaluate the effects of progressive resistance training on muscle strength, muscle tone, gait performance and perceived participation after stroke. Design: A randomized controlled trial. Subjects: Twenty-four subjects (mean age 61 years (standard deviation 5)) 6-48 months post-stroke. Methods: The training group (n = 15) participated in supervised progressive resistance training of the knee muscles (80% of maximum) twice weekly for 10 weeks, and the control group (n = 9) continued their usual daily activities. Both groups were assessed before and after the intervention and at follow-up after 5 months. Muscle strength was evaluated dynamically and isokinetically (60 degrees/sec) and muscle tone by the Modified Ashworth Scale. Gait performance was evaluated by Timed "Up & Go", Fast Gait Speed and 6-Minute Walk tests, and perceived participation by Stroke Impact Scale. Results: Muscle strength increased significantly after progressive resistance training with no increase in muscle tone and improvements were maintained at follow-up. Both groups improved in gait performance, but at follow-up only Timed "Up & Go" and perceived participation were significantly better for the training group. Conclusions: Progressive resistance training is an effective intervention to improve muscle strength in chronic stroke. There appear to be long-term benefits, but further studies are needed to clarify the effects, specifically of progressive resistance training on gait performance and participation.