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Abstract

Objective:

To investigate whether isokinetic muscle strengthening improves muscle strength, mobility, and gait in post-stroke patients.

Methods:

We searched for randomized controlled trials at PubMed/Medline, SciELO, PEDro, and Cochrane Central Register of Controlled Trials, from the earliest date available to June 2018. Randomized controlled trials that examined the effects of isokinetic muscle strengthening versus other rehabilitation interventions or control in post-stroke patients were included. Study quality was evaluated using the PEDro scale. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I² test.

Results:

In total, 13 studies (347 patients) focusing on the use of isokinetic in rehabilitation following stroke were included. All trials were of low-to-moderate quality. Isokinetic muscle strengthening improved muscle strength WMD 0.8 (95% CI: 0.2, 1.4; N = 96), mobility WMD −2.03 seconds (95% CI: −2.9, −1.1; N = 111) and gait speed WMD 0.9 m/s (95% CI: 0.05, 1.8; N = 87).

Conclusion:

Isokinetic muscle strengthening seems to be a useful strategy for improving muscle strength, mobility, and gait in post-stroke patients.

Keywords

Mobility muscle strengthening rehabilitation stroke

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References

Hunnicutt

Gregory

CM.

Skeletal muscle changes following stroke: a systematic review and comparison to healthy individuals. Top Stroke Rehabil 2017; 24(6): 463–471.

English

McLennan

Thoirs

et al . Loss of skeletal muscle mass after stroke: a systematic review. Int J Stroke 2010; 5(5): 395–402.

Kristensen

Stenager

Dalgas

Muscle strength and post-stroke hemiplegia: a systematic review of muscle strength assessment and muscle strength impairment. Arch Phys Med Rehabil 2017; 98(2): 368–380.

Hammami

Coroian

Julia

et al . Isokinetic muscle strengthening after acquired cerebral damage: a literature review. Ann Phys Rehabil Med 2012; 55(4): 279–291.

Moher

Liberati

Tetzlaff

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535.

Higgins

JPT

Green

. Cochrane handbook for systematic reviews of interventions. Chichester: John Wiley & Sons, 2006.

Olivo

Macedo

Gadotti

et al . Scales to assess the quality of randomized controlled trials: a systematic review. PhysTher 2008; 88(2): 156–175.

Verhagen

de Vet

HCW

de Bie

et al . The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 1998; 51(12): 1235–1241.

Maher

Sherrington

Herbert

et al . Reliability of the PEDro scale for rating of quality randomized controlled trials. PhysTher 2003; 83(8): 713–721.

10.

Higgins

Thompson

Deeks

et al . Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557–560.

11.

The Cochrane Collaboration, www.cochrane.org (accessed 3 February 2008).

12.

Coroian

Jourdan

Bakhti

et al . Upper limb isokinetic strengthening versus passive mobilization in patients with chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil 2018; 99(2): 321–328.

13.

Gharib

Mohamed

RA.

Isokinetic strength training in patients with stroke: effects on muscle strength, gait and functional mobility. Int J Physiother Res 2017; 5(2): 1976–1986.

14.

Singhal

Pattnaik

Mohanty

Comparison of isokinetic strengthening with functional strengthening of lower limb and their effect on gait in hemiparesis due to stroke. J Neurol Neurorehabil Res 2017; 2(1): 46–54.

15.

Chen

Chang

et al . Comparison of the effects between isokinetic and isotonic strength training in subacute stroke patients. J Stroke Cerebrovasc Dis 2015; 24(6): 1317–1323.

16.

Şen

Sibel

ÖD

Timur

et al . Effects of the bilateral isokinetic strengthening training on functional parameters, gait, and the quality of life in patients with stroke. Int J Clin Exp Med 2015; 8(9): 16871–16879.

17.

Lee

S-B

Kang

K-Y.

The effects of isokinetic eccentric resistance exercise for the hip joint on functional gait of stroke patients. J Phys Ther Sci 2013; 25(9): 1177–1179.

18.

Milot

M-H

Sylvie

Denis

et al . Gait performance and lower-limb muscle strength improved in both upper-limb and lower-limb isokinetic training programs in individuals with chronic stroke. ISRN Rehabil 2013; 2013: 929758.

19.

Sekhar

Madhavi

Srikumari

et al . Efficacy of isokinetic strength training and balance exercises on lower limb muscles in subjects with stroke. Int J Physiother Res 2013; 2013(2): 25–29.

20.

Shimodozono

Kawahira

Ogata

et al . Addition of an anabolic steroid to strength training promotes muscle strength in the nonparetic lower limb of poststroke hemiplegia patients. Int J Neurosci 2010; 120(9): 617–624.

21.

Kim

D-H

T-I

Kim

J-S

et al . The effects of isokinetic strengthening of trunk muscles on balance in hemiplegic patients. Ann Rehabil Med 2008; 32(3): 280–284.

22.

Seo

Kim

et al . Effect of isokinetic eccentric knee extensor and flexor strengthening exercise in patients with chronic hemiplegia. J Korean Acad Rehabil Med 2003; 27(6): 824–829.

23.

Kim

Eng

MacIntyre

et al . Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study. J Stroke Cerebrovasc Dis 2001; 10(6): 265–273.

24.

Engardt

Knutsson

Jonsson

et al . Dynamic muscle strength training in stroke patients: effects on knee extension torque, electromyographic activity, and motor function. Arch Phys Med Rehabil 1995; 76(5): 419–425.

25.

Cohen

Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.

26.

Bohannon

Glenney

SS.

Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review. J Eval Clin Pract 2014; 20(4): 295–300.

27.

Bohannon

Crouch

Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract 2017; 23(2): 377–381.

28.

Coudeyre

Jegud

Giustanini

et al . Isokinetic muscle strengthening for knee osteoarthritis: a systematic review of randomized controlled trials with meta-analysis. Ann Phys Rehabil Med 2016; 59(3): 207–215.

29.

Pipes

Wilmore

JH.

Isokinetic versus isotonic strength training in adult men. Med Sci Sports 1975; 7: 262–274.

30.

Wist

Clivaz

Sattelmayer

Muscle strengthening for hemiparesis after stroke: a meta-analysis. Ann Phys Rehabil Med 2016; 59(2): 114–124.

31.

Ghroubi

Kossemtini

Mahersi

et al . Contribution of isokinetic muscle strengthening in the rehabilitation of obese subjects. Ann Phys Rehabil Med 2016; 59(2): 87–93.

32.

Gremeaux

Croisier

Forthomme

Isokinetic intervention in microtraumatic shoulder instability: an update. J Sport Med Phys Fit 2012; 52(4): 413–423.

33.

Inaba

Edberg

Montgomery

et al . Effectiveness of functional training, active exercise, and resistive exercise for patients with hemiplegia. Phys Ther 1973; 53(1): 28–35.

34.

Patten

Lexell

Brown

HE.

Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy. J Rehabil Res Dev 2004; 41(3A): 293–312.

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Effects of isokinetic muscle strengthening on muscle strength,mobility,and gait in post-stroke patients: a systematic review and meta-analysis