title: High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors.
abstract: OBJECTIVE
  To evaluate the efficacy of supervised high-intensity progressive resistance training (PRT) on lower extremity strength, function, and disability in older, long-term stroke survivors.
  
  
  METHODS
  Forty-two volunteers aged 50 years and above, 6 months to 6 years after a single mild to moderate stroke, were randomized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press (LP), unilateral paretic and nonparetic knee extension (KE), ankle dorsiflexion (DF), and plantarflexion (PF) exercises. Functional performance was assessed using the 6-minute walk, stair-climb time, repeated chair-rise time, and habitual and maximal gait velocities. Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument (LLFDI).
  
  
  RESULTS
  Single-repetition maximum strength significantly improved in the PRT group for LP (16.2%), paretic KE (31.4%), and nonparetic KE (38.2%) with no change in the control group. Paretic ankle DF (66.7% versus -24.0%), paretic ankle PF (35.5% versus -20.3%), and nonparetic ankle PF (14.7% versus -13.8%) significantly improved in the PRT group compared with the control. The PRT group showed significant improvement in self-reported function and disability with no change in the control. There was no significant difference between groups for any performance-based measure of function.
  
  
  CONCLUSIONS
  High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke, and results in reductions in functional limitations and disability.
authors.affiliation: Human Physiology Laboratory, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Mass 02215, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Ouellette
authors.forename: Nathan K
authors.initials: NK
authors.lastname: LeBrasseur
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
authors.forename: Edward
authors.initials: E
authors.lastname: Phillips
authors.forename: Joel
authors.initials: J
authors.lastname: Stein
authors.forename: Walter R
authors.initials: WR
authors.lastname: Frontera
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009132:Muscles / Q000503:physiopathology; D010349:Patient Compliance; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D017741:Survivors; D016896:Treatment Outcome