POWER training in chronic stroke individuals: differences between responders and nonresponders

Abstract

Background Lower extremity muscle weakness is a primary contributor to post-stroke dysfunction. Resistance training is an effective treatment for hemiparetic weakness and improves walking performance. Post-stroke subject characteristics that do or do not improve walking speed following resistance training are unknown. Objective The purpose of this paper was to describe baseline characteristics, as well as responses to training, associated with achieving a minimal clinically important difference (MCID) in walking speed (≥0.16 m/s) following Post-stroke Optimization of Walking Using Explosive Resistance (POWER) training. Methods Seventeen participants completed 24 sessions of POWER training, which included intensive progressive leg presses, jump training, calf raises, sit-to-stands, step-ups, and over ground fast walking. Outcomes included SSWS, FCWS, DGI, FMA-LE, 6-MWT, paretic knee power, non-paretic knee power, and paretic step ratio. Results Specific to those who reached MCID in SSWS (e.g. “responders”), significant improvements in SSWS, FCWS, 6-MWT, paretic knee power, and non-paretic knee power was realized. Paretic knee power and non-paretic knee power significantly improved in those who did not achieve MCID for gait speed (e.g. “non-responders”). Conclusion The potential for POWER training to enhance general locomotor function was confirmed. Baseline paretic knee strength/power may be an important factor in how an individual responds to this style of training. The lack of change within the non-responders emphasizes the contribution of factors other than lower extremity muscle power improvement to locomotor dysfunction.

Evoking the Withdrawal Reflex via Successive Needle‐Pricking on the Plantar and Dorsal Aspect of the Foot Increases the FMA of the Lower Limb for Poststroke Patients in Brunnstrom Stage III: A Preliminary Study

“…The improvement of hip flexion is beneficial for patients, as it alleviates extensor spasms and prevents venous thrombosis. The strength of the lower limb muscles has an important impact on the balance and walking function in patients with poststroke hemiplegia [ 21 ]. The significant improvement in hip flexion/extension, knee flexion/extension, and ankle flexion/extension in the MMT-LL in the intervention group indicated the recovery of muscle strength, which would enhance the quality of life of the patients.…”

Recovery of mobility function and life-space mobility after ischemic stroke: the MOBITEC-Stroke study protocol

“…Tests will be performed after a period of familiarisation and warm-up. It has been shown in various studies that testing of muscle power (and even ballistic power training) [ 76 , 77 ] can be performed safely in patients with stroke [ 76 , 78 ], in other clinical populations [ 79 ], and in mobility-limited [ 72 ], and healthy older adults [ 75 , 80 ].…”

The effectiveness of group exercise for improving activity and participation in adult stroke survivors: a systematic review

“…Approximately 35% of stroke survivors with initial paralysis of the lower limb do not regain useful function and 20 to 25% of these survivors are unable to walk without full assistance at 6 months [2]. The remaining 65% of survivors who are able ambulate independently experience an increased effort in walking tasks and changes to physical function and participation in other daily activities [3]. This can cause a loss of fitness, activity and independence which contributes to increased social needs and the development of comorbidities such as diabetes and an increased risk of depression [3].…”

“…The remaining 65% of survivors who are able ambulate independently experience an increased effort in walking tasks and changes to physical function and participation in other daily activities [3]. This can cause a loss of fitness, activity and independence which contributes to increased social needs and the development of comorbidities such as diabetes and an increased risk of depression [3].…”