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Strengthening interventions increase strength and improve activity after stroke: a systematic review
Louise Ada1, Simone Dorsch, Colleen G Canning
1Faculty of Health Science, The University of Sydney, Lidcombe, NSW 1825, Australia. L.Ada@fhs.usyd.au
The Australian Journal of Physiotherapy
|November 30, 2006
Summary
Strength training after stroke effectively improves strength and activity without increasing spasticity. These findings support incorporating strengthening programs into post-stroke rehabilitation for better patient outcomes.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Trials
Background:
- Stroke survivors often experience significant muscle weakness and functional limitations.
- Spasticity is a common secondary complication that can impede recovery and participation in rehabilitation.
- The efficacy and safety of strength training in stroke rehabilitation remain areas of active investigation.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials evaluating the effectiveness and safety of strength training interventions in stroke survivors.
- To determine if strength training improves muscle strength and functional activity post-stroke.
- To assess the impact of strength training on spasticity levels in individuals with stroke.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials were conducted.
- Participants were categorized based on stroke phase (acute/chronic) and severity (very weak/weak).
- Strength training interventions included various methods like progressive resistance exercise and biofeedback, with strength, spasticity, and activity as primary outcomes.
Main Results:
- The meta-analysis included 15 trials with data from 21 identified studies.
- Strength training demonstrated a small positive effect on both muscle strength (SMD 0.33) and functional activity (SMD 0.32).
- There was a minimal effect on spasticity (SMD -0.13), indicating no significant increase.
Conclusions:
- Strength training interventions are effective in increasing strength and improving activity levels in stroke survivors.
- These programs do not appear to exacerbate spasticity, suggesting a favorable safety profile.
- The findings strongly support the integration of comprehensive strengthening programs into standard stroke rehabilitation protocols.
