Balance and walking performance are improved after resistance and aerobic training in persons with chronic stroke

To investigate the effect of different types of physical training on balance performance and whether improved balance correlates with improved walking performance.

Forty eight participants with chronic stroke were randomly assigned to aerobic training on cycle ergometer (AT-group), resistance training of the lower extremities (RT-group), or sham training of upper extremities (ST-group). Participants exercised 3 d/week for 12 weeks. Balance (Berg Balance Scale), peak oxygen uptake rate, isometric knee extensor strength, maximal gait speed, and 6 minute walk test were measured at baseline and after 12 weeks.

Training specific effects were observed; the AT-group improved peak oxygen uptake rate by 15.5 (6.0-25.0)%, the RT-group improved non-paretic knee extensor strength by 35.1 (18.3-51.9)% and the ST-group improved non-paretic knee extensor strength by 8.9 (0.7-17.1)%. All groups improved balance (6.0 (95% CI: 3.2-8.8)%), maximal gait speed (10.2 (6.5-14.0)%), and 6 minute walk distance (12.4 (8.8-15.9)%) but balance improvements did not correlate with improvements in muscle strength, peak oxygen uptake rate, or walking.

Physical exercise improves balance and walking performance, but improved balance is not a prerequisite for functional improvements in chronic stroke. Implications for Rehabilitation Aerobic training and progressive resistance training show small significant improvements in balance and walking, indicating a possible clinical relevance of these training modalities. Improvements in balance may not be a prerequisite for improvements in walking distance when assistive devices are allowed during walking tests.