Maximal strength training enhances strength and functional performance in chronic stroke survivors

Objective: This study aimed to demonstrate that maximal strength training improves muscle strength and to assess the effect of training on function, aerobic status, and quality-of-life among chronic stroke survivors. Design: Ten patients acted as their own controls for 4 wks, before an 8-week training intervention. Patients trained 3 days/wk, with four sets of four repetitions at 85%–95% one repetition maximum in unilateral leg press and plantarflexion with an emphasis on maximal mobilization of force in the concentric phase. Results: After training, leg press strength improved by 30.6 kg (75%) and 17.8 kg (86%); plantarflexion strength improved by 35.5 kg (89%) and 28.5 kg (223%) for the unaffected and affected limbs, respectively, significantly different from the control period (all P < 0.01). The 6-min walk test improved by 13.9 m (within training period; P = 0.01), and the Timed Up and Go test time improved by 0.6 secs (within training period; P < 0.05). There were no significant changes in walking economy, peak aerobic capacity, Four-Square Step Test, or health-related quality-of-life after training. Conclusions: Maximal strength training improved muscle strength in the most affected as well as in the nonaffected leg and improved Timed-Up-And-Go time and 6-min walk distance but did not alter Four-Step Square Test time, aerobic status, or quality-of-life among chronic stroke survivors

Effect of high aerobic intensity interval treadmill walking in people with chronic stroke: a pilot study with one year follow-up

Objective: To determine the physiological and functional responses from high aerobic intensity treadmill walking in 4 x 4-minute intervals in people with chronic stroke and to evaluate the feasibility of this mode of training. Method: This was a baseline control trial with 1 year follow-up in an outpatient rehabilitation setting at a university hospital. Eight people with chronic stroke participated in and completed the study. Their mean age was 48.9 (± 10.6) years. We tested uphill treadmill walking in 4 x 4-minute work periods at an intensity between 85% and 95% of peak heart rate from initial maximal treadmill testing. There were 3-minute active breaks between the intervals. The main outcome measures were peak oxygen uptake (VO2peak) and walking economy (Cw). Overall compliance and adverse events determine the feasibility. Results: VO2peak increased from 2.32 (± 0.44) to 2.60 (± 0.55) L • min–1 post training (P = .003). Walking economy (Cw) improved from 1.12 (± 0.15) to 1.04 (± 0.18) L • min–1 (P = .043). At 1 year follow-up, VO2peak was 2.59 (±0.58) L • min –1 and was not significantly different from posttraining measurement (P = 1.00). Cw was 1.19 (± 0.15) L • min–1 at 1 year follow-up and thus was worse than post training (P = .023). Functional improvements were found in the 6-minute walk test (6MWT) (P = .020), 10-meter walk test (10MWT) (P = .032), and Timed Up and Go test (TUG) (P = .002) at post tests. Conclusions: High aerobic intensity interval treadmill walking significantly increased VO2peak and improved Cw in these subjects. The training was feasible and may have important implications for cardiovascular health and future rehabilitation programs in this population