Effect of strengthening exercise in addition to task-specific gait training after stroke: a randomised trial

Abstract

Rationale: Gait deficits contribute considerably to functional disability after stroke, and the regaining of walking ability is a major goal in most stroke rehabilitation programmes. Evidence suggests that muscular strengthening exercises after stroke can improve strength and activity. Additionally, task-related practice performed at high intensities may enhance walking competency in people with stroke. However, there is insufficient evidence to conclude which approach is most effective.

Aim: This study will test the hypothesis that task-specific walking training plus targeted strength training is superior to task-specific walking training alone in improving strength, motor co-ordination, quality of independent walking, and participation in acute stroke patients.

Design: This trial is a prospective, randomised clinical trial. People after stroke who are living at home and attending outpatient clinics will be randomly allocated into either an experimental or a control group. The experimental group will undertake task-specific walking training, plus targeted strength training three times per week over 10 weeks, while the control group will only undertake task-specific walking training. At baseline, after 10 weeks of intervention and 4 weeks after the cessation of the interventions, allocation-blinded researchers will collect outcome measures.

Study outcomes: Primary outcomes will be measured for levels of impairment (strength and co-ordination), activity (quality of walking), and participation (quality of life). Secondary outcomes will be the minimal clinically important differences of lower limb strength, motor co-ordination, and gait speed.