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Effects of Resistance Training and Aerobic Training on Ambulation in Chronic Stroke

Severinsen, Kaare MD, PhD; Jakobsen, Johannes K. MD, PhD; Pedersen, Asger R. PhD; Overgaard, Kristian PhD; Andersen, Henning MD, PhD

American Journal of Physical Medicine & Rehabilitation: January 2014 - Volume 93 - Issue 1 - p 29–42
doi: 10.1097/PHM.0b013e3182a518e1
Original Research Articles

Objective The aim of this study was to directly compare the effects of aerobic training (AT) with progressive resistance training (RT) after stroke to determine whether AT-induced fitness gains or RT-induced strength gains translate into improved ambulation across a 12-wk intervention and whether gains are retained 1 yr after cessation of formal training.

Design This study is a randomized controlled 12-wk intervention trial with a 1-yr follow-up. Forty-three community-dwelling independent walkers with a chronic ischemic hemiparetic stroke were allocated to AT using a cycle ergometer (n = 13), RT using training machines (n = 14), or low-intensity sham training of the arms (n = 16). The main outcome measures were 6-min walk distance and fast 10-m walking speed.

Results Comparisons between AT, RT, and sham training revealed no clinically relevant effects on walking velocity or walking distance. Muscle strength improved after RT (P < 0.0001) and was preserved at 1-yr follow-up (P < 0.001). Aerobic capacity increased after AT (P < 0.001) but was lost during the follow-up observation period.

Conclusions Improvement of muscle strength or aerobic capacity using non–task-specific training methods does not result in improved ambulation in patients with chronic stroke. Muscle strength gains were maintained at follow-up, whereas all improvements of aerobic capacity were lost, indicating a long-lasting effect of intensive RT even without maintenance training.

From the Hammel Neurorehabilitation and Research Centre, Hammel, Denmark (KS, ARP); Rigshospitalet, Neurocentret, Copenhagen, Denmark (JKJ); Department of Public Health–Section of Sport Science, Aarhus University (KO); and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark (HA).

All correspondence and requests for reprints should be addressed to: Kaare Severinsen, MD, PhD, The Research Unit, Hammel Neurorehabilitation and Research Centre, Voldbyvej 15, 8450 Hammel, Denmark.

Supported by grants from the VELUX Foundation and the BEVICA Foundation, both in Denmark.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.