Balance and walking performance are improved after resistance and aerobic training in persons with chronic stroke.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.