Abstract - Weakness and strength training in persons with poststroke hemiplegia: Rationale, method, and efficacy

Carolynn Patten, PhD, PT; Jan Lexell, MD, PhD; Heather E. Brown, MSPT

Neuromuscular Systems Section, Rehabilitation Research and Development Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Department of Rehabilitation, Lund University Hospital, Lund, Sweden; Department
of Community Medicine, Lund University, Malmö, Sweden; Department of Health Sciences, Luleå University
of Technology, Boden, Sweden

Abstract — Several converging lines of contemporary evidence suggest that weakness presents a more serious compromise to movement function in poststroke hemiplegia than spasticity. This review examines the clinical and functional phenomena of weakness in poststroke hemiplegia, currently available evidence identifying physiologic substrates contri-buting to weakness, and reports of early investigations involving high-resistance training targeted at improving strength and the transfer of strength to improvements in functional capacity. Based on this information, we describe some unsolved problems and indicate some likely lines of development to increase our knowledge regarding how resistance training can be included in effective stroke rehabilitation.

Key words: adaptation, physiological; cerebrovascular accident; evidence-based medicine; hemiplegia; muscles, skeletal; muscle weakness; recovery of function; rehabilitation; treatment outcome.

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