Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial

OBJECTIVE: To determine the effectiveness of progressive resistance strengthening exercises to improve gross motor function and walking in patients receiving intensive rehabilitation after stroke. DESIGN: Randomized controlled trial. SETTING: Five inpatient rehabilitation programs affiliated with teaching hospitals. PARTICIPANTS: Inclusion criteria included less than 6 months poststroke and recovery of the leg stages 3 to 5 on the Chedoke-McMaster Stroke Assessment (CMSA). INTERVENTIONS: Both groups received conventional physical therapy programs. In addition, the experimental group performed 9 lower-extremity progressive resistance exercises 3 times a week for the duration of their stay, whereas the control group did the same exercises and for the same duration but without resistance. MAIN OUTCOME MEASURES: The Disability Inventory of the CMSA and the 2-minute walk test (2MWT) at baseline, 4 weeks, discharge, and 6 months after discharge. RESULTS: Over the length of stay, the rate of change in the Disability Inventory was.27 points per day in the experimental group and.29 points per day in the control group; the between-group difference was -.02 points per day (95% confidence interval [CI], -.10 to.06; P=.62). At discharge, the rate of change in the 2MWT was -.01 m in the experimental group and.15m in the control group; the between-group difference was -.16 m (95% CI, -.37 to.05; P=.14). CONCLUSIONS: Progressive resistance strengthening exercises as applied in our study were not effective when compared with the same exercises given without resistance.