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Strength Training Associated with Task-Oriented Training to Enhance Upper-Limb Motor Function in Elderly Patients with Mild Impairment After Stroke: A Randomized Controlled Trial

da Silva, Paulo Bazile MSc; Antunes, Fabiane Nunes PT; Graef, Patrícia MSc; Cechetti, Fernanda PhD; Pagnussat, Aline de Souza PhD

American Journal of Physical Medicine & Rehabilitation: January 2015 - Volume 94 - Issue 1 - p 11–19
doi: 10.1097/PHM.0000000000000135
Original Research Articles
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Objective The aim of this study was to verify the effects of loaded exercises associated with a task-oriented training (TOT) program in the recovery of upper-limb function in individuals with chronic hemiparesis after stroke.

Design This study used a single-blinded, randomized controlled trial. Patients were included into two TOT groups: one that performed the task-oriented therapy without load (TOT group, n = 10) and another one that performed task-oriented therapy with personalized resistance (TOT_ST group, n = 10) for 6 wks, for a total of 12 sessions. Main measures included The Upper Extremity Performance Test, shoulder flexor and handgrip strength, shoulder active range of motion, motor impairment (Fugl-Meyer Scale), and muscle tone.

Results The TOT_ST group demonstrated better scores relating to unilateral tasks and in the quality aspects of bilateral movements (The Upper Extremity Performance Test, P = 0.04) at the end of rehabilitation protocol. The highest muscle force gain was reached by the TOT_ST group for the shoulder flexors (P = 0.001). Similarly, the active range of motion (P = 0.01) and Fugl-Meyer scores (P = 0.001) were higher in the TOT_ST group compared with the TOT group. Both groups showed improvement after training.

Conclusions Strength training was able to intensify the upper-limb rehabilitation, as demonstrated by the superior scores achieved by the TOT_ST group in most of the evaluated parameters. Muscle strength training might be a pivotal element of the task-oriented rehabilitation program of chronic patients with mild impairment after stroke.

From the Programa de Pós-graduação em Ciências da Reabilitação (PBdS, FNA, FC, ASP), Departamento de Fisioterapia (PG, FC, ASP), and Programa de Pós Graduação em Ciências da Saúde (ASP), Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

All correspondence and requests for reprints should be addressed to: Aline de Souza Pagnussat, PhD, Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil.

Supported by grants from the Brazilian agencies CNPq (National Council of Technological and Scientific, Brazil) and the National Council for the Improvement of Higher Education (CAPES-Brazil).

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.

© 2015 by Lippincott Williams & Wilkins