Does functional strength training of the leg in subacute stroke improve physical performance? A pilot randomized controlled trial.


OBJECTIVE To examine the effect of functional strength training in subacute stroke. DESIGN A single-blinded randomized controlled trial. SETTING Two rehabilitation units. SUBJECTS Eighteen patients in the subacute phase post stroke, randomly allocated to a functional strength training (intervention) group (n = 8) and a training-as-usual (comparison) group (n = 10). INTERVENTION The functional strength training group participated in functional progressive strength training of the affected lower extremity. The training-as-usual group had traditional training, excessive muscle power being avoided to prevent associated reactions. All trained 50 minutes five days a week for four weeks. MAIN MEASURES Maximum weight-bearing in standing (primary outcome), isometric muscle strength, gait speed and items of Motor Assessment Scale. RESULTS Maximum weight-bearing on the affected leg improved more in the functional strength training group (mean 17.4% of body weight) than in the training-as-usual group (mean 5.6% of body weight), but taking test data at inclusion into consideration, the difference in change was not statistically significant (P = 0.056). More patients in the functional strength training group (57%) could weight-bear on the affected leg while stepping forward, than in the training-as-usual group (17%). Improvement was clinically significant in 7 of 9 outcome measures in the functional strength training group (effect size > or = 0.80, large), but in only 3 of 9 in the training-as-usual group. All patients in the functional strength training group and 70% of the patients in the training-as-usual group rated their overall status as 'much' or 'very much' improved. CONCLUSIONS This pilot study indicates that functional strength training of lower extremities improves physical performance more than traditional training.


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