Strength Training, Gait Performance, and Stroke Survivors

A patient working on his gait performance.

With this growing special population of stroke survivors, the allied health community is striving to help restore something that has been lost. Hemiparesis is one of the many side effects that stroke survivors may experience. It causes motor control impairment, to some degree, that is a result of weakness or the inability to move one side of the body.3 Depending on the severity of the survivor’s case, it can make it difficult to perform daily tasks such as holding or grasping things, reaching above their shoulder, extending their arm, stepping up or down, and even walking on flat surfaces. Regaining the motor function to perform these daily tasks should be a goal for every stroke survivor. One aspect in particular of hemiparesis is that gait performance varies depending on the severity of the hemiplegia. However, studies have shown gait performance can be improved through strength training.

According to Cramp et al., strength of the hip flexor, knee extensor, and ankle plantarflexor muscles have been shown to have a moderate to strong correlation with gait velocity.2  Studies have shown that strength of the muscle groups have been significantly improved in stroke survivors after strength training programs.1,2 Therefore, it is valid to assume that lower limb strength training should be included in exercise training for stroke survivors with hemiplegia. If muscular strength improves, it is quite possible that the gait velocity will improve as a result.

In a study conducted by Cramp et al., a significant increase in muscular strength in the paretic limb was seen from the baseline to after eight training sessions and continued to increase with more training sessions.2 They observed that both the muscular strength of the knee extensors and the gait velocity increased significantly.2 Badics et al. found that muscular strength increased significantly in all patients and this increase was positively correlated with the intensity and number of exercising sessions.1

Several studies have highlighted the benefits and improvements from strength training for stroke survivors suffering from hemiplegia, but are there any negative side effects? In a study by Badics et al. that had 56 patients, no negative side effects on muscle tone, or complications such as joint pain were found.1 In fact, it is even reported that some patients, despite having years between their stroke event and the training program, improved muscle strength and gained empowerment for activities of daily living.1

Interested in learning more about current exercise prescriptions for stroke survivors? Check out my blog here.

1 Badics, E., Wittmann, A., Rupp, M., Stabuer, B., & Zifko, U. (2002). Systematic muscle building exercises in the rehabilitation of stroke patients. NeuroRehabilitation, 17(3), 211-214.

2 Cramp, M., Greenwood, R., Gill, M., Rothwell, J., & Scott, O. (2006). Low intensity strength training for ambulatory stroke patients. Disability & Rehabilitation, 28(13-14), 883-889.

3 Effects of stroke. (2012). Retrieved September 14, 2014, from http://www.stroke.org/site/PageServer?pagename=effects