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Strength Training for Walking in Neurologic Rehabilitation Is Not Task Specific: A Focused Review

Williams, Gavin PhD, FACP; Kahn, Michelle B App Sci; Randall, Alana B App Sci

American Journal of Physical Medicine & Rehabilitation: June 2014 - Volume 93 - Issue 6 - p 511–522
doi: 10.1097/PHM.0000000000000058
Literature Review

ABSTRACT: The aim of this systematic review was to investigate the task specificity of strength training programs for walking in neurologic rehabilitation. Nine electronic databases were searched from conception to October 2012 for randomized controlled trials that used strength training to improve walking in adult neurologic populations. The search identified 25 randomized controlled trials that investigated the efficacy of strength training to improve walking in people with a variety of neurologic conditions. The results revealed that despite significant strength gains, many studies failed to show a significant improvement in walking capacity. Most studies did not include exercises relating to all three main power events important for walking. Strength testing and strengthening exercises were prioritized for the knee extensors and flexors, despite their relatively minor role in human walking. Strengthening exercises performed in the neurologic population are not specific to the main muscle groups responsible for the power generation required for walking. There is a predisposition for strength testing and strengthening exercises to focus on the knee flexors and extensors despite their relatively minor role during walking. Further consideration of the specificity of strength training may provide greater translation of strength gains to improved walking outcomes.

From the Epworth Hospital, Melbourne, Australia (GW, MK); The University of Melbourne, Melbourne, Australia (GW); La Trobe University, Melbourne, Australia (GW); and Northern Health, Melbourne, Australia (AR).

All correspondence and requests for reprints should be addressed to Gavin Williams, PhD, FACP, Physiotherapy Department, Epworth Hospital, 89 Bridge Rd, Richmond, 3121, Victoria, Australia.

An abstract related to this review has been accepted at the 17th International Movement Disorders Congress, Sydney, Australia.

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.

© 2014 by Lippincott Williams & Wilkins