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Strength training in spastic hemiparesis: should it be avoided?
1Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610-0154, USA.
Neurorehabilitation
|February 15, 2014
Summary
Graded resistive exercise may benefit, not harm, spastic muscles in stroke survivors. This strength training approach can improve muscle function and reduce weakness in affected limbs.
Area of Science:
- Neurology
- Physical Therapy
- Rehabilitation Medicine
Background:
- Controversy exists regarding resistive exercise for post-stroke spasticity.
- Bobath's approach suggested avoiding effort to prevent increased cocontraction and reduced coordination.
- These theories lack empirical support in clinical practice.
Purpose of the Study:
- To investigate the clinical assumption that graded resistive exercise worsens spasticity and impairs motor control.
- To evaluate the effects of graded resistive exercise on force production and modulation in spastic post-stroke individuals.
Main Methods:
- Nine hemiplegic subjects with spasticity participated.
- Graded resistive exercise was performed with simultaneous measurements.
- Key metrics included cocontraction, spasticity levels, and fractionated reaction time.
Main Results:
- Little difference was observed between paretic and non-paretic muscle responses to exercise.
- Resistive exercise demonstrated a potentially beneficial effect on paretic muscle performance.
- No detrimental impact on spastic muscle function was identified.
Conclusions:
- Graded resistive exercise is not detrimental to spastic muscles post-stroke.
- This exercise modality should be considered for remediation of weakness and functional deficits.
- Evidence supports incorporating strength training into stroke rehabilitation protocols.
