Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors

Objective: To evaluate the impact of a program of muscle strengthening and physical conditioning on impairment and disability in chronic stroke subjec ts. Design: A randomized pretest and posttest control group, followed by a sing le-group pretest and posttest design. Subjects: Thirteen community-dwelling stroke survivors of at least 9 months . Intervention: A 10-week (3 days/week) program consisting of a warm-up, aero bic exercises, lower extremity muscle strengthening, and a cool-down. Main Outcome Measures: Peak isokinetic torque of the major muscle groups of the affected lower limb, quadriceps and ankle plantarflexor spasticity, ga it speed, rate of stair climbing, the Human Activity Profile (HAP), and the Nottingham Health Profile (NHP) were recorded twice for the treatment grou p and three times for the control group. Results: Significant improvements were found for all the selected outcome m easures (HAP, NHP, and gait speed) for the treatment group (p < .001). In t erms of overall training effects, the 13 subjects demonstrated increases in strength of the affected major muscle groups, in HAP and NHP profiles, and in gait speed and rate of stair climbing without concomitant increases in either quadriceps or ankle plantarflexor spasticity. Conclusions: The 10-week combined program of muscle strengthening and physi cal conditioning resulted in gains in all measures of impairment and disabi lity. These gains were not associated with measurable changes of spasticity in either quadriceps or ankle plantarflexors. (C) 1999 by the American Congress of Rehabilitation Medicine and the Americ an Academy of Physical Medicine and Rehabilitation.