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.