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 .15 m 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.