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

Disability and rehabilitation
October 1, 2018
Caroline Lund et al. (7 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

To investigate whether improved balance from different physical training types correlates with improved walking performance in chronic stroke patients.

Results Summary

All training groups improved balance and walking performance, but balance improvements did not correlate with muscle strength, oxygen uptake, or walking improvements. Aerobic and resistance training showed small but significant functional improvements.

Population

Forty-eight participants with chronic stroke.

Effective Dosage

3 days/week for 12 weeks.

Duration

12 weeks

Interactions

None mentioned

Extracted Claims (21)
InterventionDirectionEndpointPopulationDosageImpactClaim #
aerobic training on cycle ergometer
increase
peak oxygen uptake rate
participants with chronic stroke
15.5 (6.0-25.0)%
improved
#1
resistance training of the lower extremities
increase
non-paretic knee extensor strength
participants with chronic stroke
35.1 (18.3-51.9)%
improved
#2
sham training of upper extremities
increase
non-paretic knee extensor strength
participants with chronic stroke
8.9 (0.7-17.1)%
improved
#3
aerobic training on cycle ergometer
increase
balance
participants with chronic stroke
6.0 (95% CI: 3.2-8.8)%
improved
#4
resistance training of the lower extremities
increase
balance
participants with chronic stroke
6.0 (95% CI: 3.2-8.8)%
improved
#5
sham training of upper extremities
increase
balance
participants with chronic stroke
6.0 (95% CI: 3.2-8.8)%
improved
#6
aerobic training on cycle ergometer
increase
maximal gait speed
participants with chronic stroke
10.2 (6.5-14.0)%
improved
#7
resistance training of the lower extremities
increase
maximal gait speed
participants with chronic stroke
10.2 (6.5-14.0)%
improved
#8
sham training of upper extremities
increase
maximal gait speed
participants with chronic stroke
10.2 (6.5-14.0)%
improved
#9
aerobic training on cycle ergometer
increase
6 minute walk distance
participants with chronic stroke
12.4 (8.8-15.9)%
improved
#10
resistance training of the lower extremities
increase
6 minute walk distance
participants with chronic stroke
12.4 (8.8-15.9)%
improved
#11
sham training of upper extremities
increase
6 minute walk distance
participants with chronic stroke
12.4 (8.8-15.9)%
improved
#12
aerobic training on cycle ergometer
no change
muscle strength
participants with chronic stroke
-
balance improvements did not correlate with improvements
#13
resistance training of the lower extremities
no change
muscle strength
participants with chronic stroke
-
balance improvements did not correlate with improvements
#14
sham training of upper extremities
no change
muscle strength
participants with chronic stroke
-
balance improvements did not correlate with improvements
#15
aerobic training on cycle ergometer
no change
peak oxygen uptake rate
participants with chronic stroke
-
balance improvements did not correlate with improvements
#16
resistance training of the lower extremities
no change
peak oxygen uptake rate
participants with chronic stroke
-
balance improvements did not correlate with improvements
#17
sham training of upper extremities
no change
peak oxygen uptake rate
participants with chronic stroke
-
balance improvements did not correlate with improvements
#18
aerobic training on cycle ergometer
no change
walking
participants with chronic stroke
-
balance improvements did not correlate with improvements
#19
resistance training of the lower extremities
no change
walking
participants with chronic stroke
-
balance improvements did not correlate with improvements
#20
sham training of upper extremities
no change
walking
participants with chronic stroke
-
balance improvements did not correlate with improvements
#21
Abstract

PURPOSE: To investigate the effect of different types of physical training on balance performance and whether improved balance correlates with improved walking performance. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Medical Subject Headings (MeSH)
AgedExerciseExercise TestExercise TherapyFemaleHumansMaleMiddle AgedMuscle StrengthPostural BalanceResistance TrainingStrokeStroke RehabilitationTreatment OutcomeWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations33
Citations/Year4.7
Relative Citation Ratio2.67
NIH Percentile82.4%
Research Impact Scores
APT Score0.95
Weight Score2.29
Normalized Score0.67
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