title: "Task-oriented" exercise improves hamstring strength and spastic reflexes in chronic stroke patients.
abstract: OBJECTIVE
  Despite the belief that after cerebral infarction only limited functional gains are possible beyond the subacute period, we tested the hypothesis that a 12-week program of "task-oriented" treadmill exercise would increase muscle strength and decrease spastic reflexes in chronic hemiparetic patients.
  
  
  METHODS
  Fourteen subjects, aged 66+/-3 (mean+/-SEM) years, with residual gait deviations due to remote stroke (>6 months), underwent repeated measures of reflexive and volitional (concentric and eccentric) torque with use of isokinetic dynamometry on the hamstring musculature bilaterally. Torque output was measured at 4 angular velocities (30(o), 60(o), 90(o), and 120(o)/s).
  
  
  RESULTS
  After 3 months of 3 times/wk low-intensity aerobic exercise, there were significant main effects (2 legs [P<0.01]x2 times [P<0. 01]x4 angular velocities [P<0.05]) for concentric torque production. Torque/time production in the concentric mode also improved significantly in the paretic (50%, P<0.01) and nonparetic hamstrings (31%, P<0.01). Eccentric torque/time production increased by 21% (P<0.01) and 22% (P<0.01) in the paretic and nonparetic hamstrings, respectively. Passive (reflexive) torque/time generation in the paretic hamstrings decreased by 11% (P<0.027). Reflexive torque/time was unchanged in the nonparetic hamstrings (P=0.45).
  
  
  CONCLUSIONS
  These findings provide evidence that progressive treadmill aerobic exercise training improves volitional torque and torque/time generation and reduces reflexive torque/time production in the hemiparetic limb. Strength changes associated with improved functional mobility in chronic hemiparetic stroke survivors after treadmill training will be reported in future articles.
authors.affiliation: Department of Physical Therapy, Division of Gerontology, University of Maryland-Baltimore School of Medicine, Baltimore, MD, USA. gsmith@physio.ab.umd.edu
authors.forename: G V
authors.initials: GV
authors.lastname: Smith
authors.forename: K H
authors.initials: KH
authors.lastname: Silver
authors.forename: A P
authors.initials: AP
authors.lastname: Goldberg
authors.forename: R F
authors.initials: RF
authors.lastname: Macko
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology*; D012021:Reflex, Abnormal / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D013710:Tendons / Q000502:physiology*; D019415:Torque; D014836:Volition / Q000502:physiology*