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Increased workload enhances force output during pedaling exercise in persons with poststroke hemiplegia
1Rehabilitation Research and Development Center, VA Palo Alto Health Care System, Calif 94306, USA. brown@roses.stanford.edu
Stroke
|March 20, 1998
Summary
Post-stroke rehabilitation often avoids effort due to spasticity concerns. This study found that increased workload during pedaling improved plegic limb force output without worsening motor control in hemiplegia patients.
Area of Science:
- Neurorehabilitation
- Biomechanics
- Motor Control
Background:
- Post-stroke rehabilitation traditionally avoids exertion to prevent increased spasticity and abnormal reactions.
- Weakness is a known factor in post-stroke movement dysfunction.
- Concerns exist that strength training may worsen abnormal tone in spastic hemiplegia.
Purpose of the Study:
- To investigate the effects of increased workload on motor performance during pedaling exercise in individuals with poststroke hemiplegia.
- To test the hypothesis that heightened activity levels exacerbate abnormal tone imbalance.
Main Methods:
- 15 individuals with chronic poststroke hemiplegia and 12 healthy elderly subjects participated.
- Subjects pedaled at 12 randomized workload and cadence combinations.
- Pedal reaction forces and electromyograms from seven leg muscles were recorded.
Main Results:
- The plegic leg demonstrated increased net mechanical work with higher workloads in 75 out of 81 trials.
- This increase in work occurred without a corresponding rise in inappropriate muscle activity percentage.
Conclusions:
- Individuals with hemiplegia can increase force output in their plegic limb during higher workloads without worsening motor control.
- Exertional pedaling exercise is a beneficial intervention for enhancing muscular force output post-stroke.
- This approach may improve motor control impairments rather than exacerbating them.