Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review

Simone Dorsch; Louise Ada; Daniella Alloggia

doi:10.1016/j.jphys.2018.02.012

Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review

J Physiother. 2018 Apr;64(2):84-90. doi: 10.1016/j.jphys.2018.02.012. Epub 2018 Mar 27.

Authors

Simone Dorsch¹, Louise Ada², Daniella Alloggia³

Affiliations

¹ Faculty of Health Sciences, Australian Catholic University; Physiotherapy Department, Bankstown-Lidcombe Hospital.
² Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
³ Physiotherapy Department, Bankstown-Lidcombe Hospital.

PMID: 29602748
DOI: 10.1016/j.jphys.2018.02.012

Abstract

Question: Does progressive resistance training improve strength and activity after stroke? Does any increase in strength carry over to activity?

Design: Systematic review of randomised trials with meta-analysis.

Participants: Adults who have had a stroke.

Intervention: Progressive resistance training compared with no intervention or placebo.

Outcome measures: The primary outcome was change in strength. This measurement had to be of maximum voluntary force production and performed in muscles congruent with the muscles trained in the intervention. The secondary outcome was change in activity. This measurement had to be a direct measure of performance that produced continuous or ordinal data, or with scales that produced ordinal data.

Results: Eleven studies involving 370 participants were included in this systematic review. The overall effect of progressive resistance training on strength was examined by pooling change scores from six studies with a mean PEDro score of 5.8, representing medium quality. The effect size of progressive resistance training on strength was 0.98 (95% CI 0.67 to 1.29, I²=0%). The overall effect of progressive resistance training on activity was examined by pooling change scores from the same six studies. The effect size of progressive resistance training on activity was 0.42 (95% CI -0.08 to 0.91, I²=54%).

Conclusion: After stroke, progressive resistance training has a large effect on strength compared with no intervention or placebo. There is uncertainty about whether these large increases in strength carry over to improvements in activity.

Review registration: PROSPERO CRD42015025401. [Dorsch S, Ada L, Alloggia D (2018) Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review. Journal of Physiotherapy 64: 84-90].

Keywords: Meta-analysis; Progressive resistance training; Strength; Stroke; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Humans
Muscle Strength / physiology*
Resistance Training*
Stroke / physiopathology*
Stroke Rehabilitation / methods*