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.