Strength Training in Individuals with Stroke

PURPOSE: This paper reviews the mechanisms underlying the inability to generate force in individuals with stroke and summarizes the effects of strength training in these individuals. In addition, a systematic review of studies that have incorporated progressive strengthening interventions in individuals with stroke is presented. SUMMARY OF KEY POINTS: Central (e.g., motor recruitment) and peripheral (e.g., muscle atrophy) sources may alter muscle strength in individuals with stroke and further investigations are needed to partition and quantify their effects. As to the effect of strength training interventions in individuals with stroke, the majority of studies (albeit with small samples) that evaluated muscle strength as an outcome demonstrated improvements. With regard to the effect of strength training on functional outcomes in individuals with stroke, positive outcomes were found in less rigorous pre-test/post-test studies, but more conflicting results with controlled trials. CONCLUSIONS: Although there is some suggestion that strength training alone can improve muscle strength, further research is required to optimize strength training and the transfer of these strength gains to functional tasks in individuals with stroke.