The Effect of Lower Extremity Strengthening Exercise Using Sliding Stander on Balance and Spasticity in Chronic Stroke: A Randomized Clinical Trial

Abstract

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p< 0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

Effects of Resistance Training on Spasticity in People with Stroke: A Systematic Review

“…Regarding weekly frequency, it was observed that three of the studies implemented 3 sessions per week [29,30,33], and two had the maximum frequency, with 5 weekly sessions each [36,37]. Two articles showed the lowest frequency, with only two sessions per week [34,35].…”

“…In relation to the duration of the sessions, considerable variability was observed among the articles. The average duration of the sessions was 70 min, ranging from the shortest session of 30 min [29,36,37] up to the longest of 3 h [33]. It should be considered that two of the three articles that held 30-min sessions performed two sessions a day [29,37].…”

“…In terms of the interventions, four studies focused only on resistance training as an exercise modality [29,[34][35][36]. Two studies combined resistance training with conventional therapy [30,37], while two others did so with task-oriented training [31,32].…”

“…Only one intervention complemented resistance training with aerobic and functional exercises [33]. Six workouts were specifically aimed at the lower limbs [32][33][34][35][36][37], while three focused on the upper limbs [29][30][31], addressing specific aspects, such as wrist, elbow, and wrist, as well as shoulder and elbow.…”

“…Regarding the systems used to perform resistance training, three studies used dynamometers [29][30][31], and the remaining studies used a leg press [37], sliding stander [36], knee exercise machine [35], and an inertial flywheel [34]. The remaining two studies did not specify the system used.…”