RESISTANCE EXERCISE IN THE ELDERLY AFTER STROKE

Abstract

Muscle weakness is an independent predictor of function and residual disability following stroke. High intensity progressive resistance training (PRT) has been shown to restore function in elderly populations with chronic disease and frailty. However, the efficacy of high intensity PRT has not been evaluated in elderly individuals after stroke. PURPOSE To determine if high intensity PRT improves lower extremity strength and function in older, long-term stroke survivors. METHODS Volunteers were ages 50 and above, between 6 months to 5 years post a single stroke, and independently ambulated with or without an assistive device. Participants were randomized into either a strength training group (n = 12) or an upper extremity stretching group (n = 10). Stroke severity was mild to moderate as classified by the Orpington Prognostic Scale. Baseline and outcome measures of skeletal muscle one repetition maximum (1RM) for double leg press (DLP), unilateral knee extension (KE), and unilateral ankle dorsiflexion (DF) and plantarflexion (PF) were obtained in 22 volunteers (males, n = 16, females, n = 6). Functional performance tasks consisted of six-minute walk, stair climb, repeated chair rise, habitual gait velocity (HGV), and maximal gait velocity (MGV) performance. Comparisons were made using a two-factor (group, time) ANOVA with repeated measures. Statistical significance was accepted at p < 0.05. RESULTS 1RM strength improved in the strength training group for DLP (22.0% vs. 0.3%, (p = 0.0018), paretic KE (32.7% vs. −25.4%, p = 0.0046), non-paretic KE (28.4% vs. −11.7%, p = 0.0078), paretic ankle PF (45.2% vs. −32.1%, p = < 0.0001), and non-paretic ankle PF (29.0% vs. −23.9%, p = 0.0094). CONCLUSION High-intensity PRT improves lower extremity strength of both the paretic and non-paretic limbs after stroke. Supported by the Jacob and Valeria Langeloth Foundation