Saturday, February 25, 2012

Strength training for stroke survivors

When it comes to strength training I am an enthusiast.  More than that I aspire to be an evangelist.  I want people to understand and realise the benefits that come to everyone from basic strength training.  Yes, athletes benefit but so do non athletes, the office worker, the elderly and the sick.   Strength training can be simple but will benefit in so many ways - improved balance, fewer falls, better insulin sensitivity, better leptin sensitivity, better energy metabolism.  Yet all these benefits are a mystery to the average person.  Exercise is a brisk walk when some modified pushups and squats could do so much.

That was one of the ideas I am trying to get across in the Hillfit book - basic, simple strength training for hiking and backpacking.

This is another study that highlights the benefits of strength training for stroke survivors:

Maximal Strength Training Enhances Strength and Functional Performance in Chronic Stroke Survivors.

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.

Maximal strength training improved muscle strength in the most affected as well as in the non affected 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.
While this study did not look say quality of life improved, the Get up and Go test and the walk distance certainly indicate improvements in function. 

There is a similar study here (full pdf available)  High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors

Walking, getting out of a chair, climbing stairs...these are skills for which we need strength as we get older and as we get injured.


Mark C said...

Just because a study reports statistical significance doesn't mean it has any real world meaning.

To put the 'significant' results into perspective:

13.9 meters improvement over the span of six minutes amounts to approximately 2-3 extra steps (estimating based on a reduced stride length secondary to hemiparetic gait) every minute. While that can seem like a big difference, it isn't. It will not automatically change a person from a limited household ambulator to a community ambulator.

As far as the TUG is concerned, a half a second improvement is not significant either. It merely means the subjects (on average) were able to stand up, walk 10 meters down and back then sit again-a half a second quicker than the measurement prior to the intervention.

Now this isn't to say that busting someone who has had a stroke's ass with resistance training isn't the among the best remedies for gaining a higher level of function, because it is. But this study is a poor representation of the effects of strength training in CVA.

Skyler Tanner said...


When I was first getting into this my boss had been training a stroke victim using the Superslow/HIT method for a number of years. While not 100% by any stretch, the fact that this guy came in half-paralyzed and could now walk with a mere limp and open doors with what had been a rubbish arm was quite impressive.

Of course even if it is great for these people, I suspect the practitioners will continue to do the least litigious method, similar to how strength is king when aging, and the research supports this, yet the blue hairs are doing water aerobics...