Strength Training in Neurological Rehabilitation
Original Editor - Mariam Hashem
Top Contributors - Mariam Hashem, Jess Bell, Kim Jackson, Tony Lowe, Lucinda hampton, Tarina van der Stockt and Admin
Evidence for Muscle Weakness
reduced Motor control, dextrity deficits, paresis(muscle weakness) and slowness of movment are well known charectristics of upper motor neurone syndorme. is a feature for upper motor neurone syndrome.
Muscle weakness is a key physical impairement in neurological conditions limiting mobility.
Feasibility studies started 15 years ago to improve mobility by introducing strength training to neurological rehabilitation.
A study by Cooke et al in 2010[1] compared the effect of functional strength training and conventional physiotherapy improve walking speed, distance and mechanics.
Resistance training was found to improve muscle strength[2] and was found to improve functional performance if resistance training was added to functional exercises[3].
Another systematic review by Kjølhede in 2012 reported strong evidence regarding progressive resistance training on muscle strength for people with MS but the mechanism of how strength training affecting strength needs more studies in the future[4].
Progressuve resistance exercises were strongly recommended by the Australian Stroke Foundation guidelines (2017) and the AHA guidelines (2010), however, the optimal strengthening approach is still unknown[5].
Despite being effective in musle strengthening but most of the applied studies failed to show improvement in walking capacity[6].
Current Evidence in Strength training
systematc review demoenstrated improvement in strength following resistance training but limited impact on walking[4][7][8][9][10].
A study by William et al [6] aimed to investigate task specifity of strength training for walking in neurological conditions.
Task Specific Criteria for Muscle Strengthning
Based on ACSM guidelines[11]:
- Role of the muscle
- Action of the muscle
- Type of contraction
- Active range and segmental alignement
- Load
- Speed of movement
To make it specific to walking.
References[edit | edit source]
- ↑ Cooke EV, Tallis RC, Clark A, Pomeroy VM. Efficacy of functional strength training on restoration of lower-limb motor function early after stroke: phase I randomized controlled trial. Neurorehabilitation and Neural Repair. 2010 Jan;24(1):88-96.
- ↑ Royal College of Physicians Intercollegiate Stroke Working Party. National Clinical Guidelines for Stroke. 3rd ed. London,UK: Royal College of Physicians; 2008.
- ↑ Olivetti L, Schurr K, Sherrington C, et al. A novel weightbearing strengthening program during rehabilitation of older people is feasible and improves standing up more than a nonweight-bearing strengthening program: a randomised trial.Aust J Physiother. 2007:53:147-153.
- ↑ 4.0 4.1 Kjølhede T, Vissing K, Dalgas U. Multiple sclerosis and progressive resistance training: a systematic review. Multiple Sclerosis Journal. 2012 Sep;18(9):1215-28.
- ↑ Williams G, Strength Training in Neurological Rehabilitation Course, Physioplus 2019
- ↑ 6.0 6.1 Williams G, Kahn M, Randall A. Strength training for walking in neurologic rehabilitation is not task specific: a focused review. American journal of physical medicine & rehabilitation. 2014 Jun 1;93(6):511-22.
- ↑ Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Australian Journal of Physiotherapy. 2006 Jan 1;52(4):241-8.
- ↑ Morris SL, Dodd KJ, Morris ME. Outcomes of progressive resistance strength training following stroke: a systematic review. Clinical rehabilitation. 2004 Feb;18(1):27-39.
- ↑ Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Archives of physical medicine and rehabilitation. 2002 Aug 1;83(8):1157-64.
- ↑ Van De Port IG, Wood-Dauphinee S, Lindeman E, Kwakkel G. Effects of exercise training programs on walking competency after stroke: a systematic review. American Journal of Physical Medicine & Rehabilitation. 2007 Nov 1;86(11):935-51.
- ↑ American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine and science in sports and exercise. 2009 Mar;41(3):687.
