Strength training improves upper-limb function in individuals with stroke: a meta-analysis.
OBJECTIVE
After stroke, maximal voluntary force is reduced in the arm and hand muscles, and upper-limb strength training is 1 intervention with the potential to improve function.


METHODS
We performed a meta-analysis of randomized controlled trials. Electronic databases were searched from 1950 through April 2009. Strength training articles were assessed according to outcomes: strength, upper-limb function, and activities of daily living. The standardized mean difference (SMD) was calculated to estimate the pooled effect size with random-effect models.


RESULTS
From the 650 trials identified, 13 were included in this review, totaling 517 individuals. A positive outcome for strength training was found for grip strength (SMD=0.95, P=0.04) and upper-limb function (SMD=0.21, P=0.03). No treatment effect was found for strength training on measures of activities of daily living. A significant effect for strength training on upper-limb function was found for studies including subjects with moderate (SMD=0.45, P=0.03) and mild (SMD=0.26, P=0.01) upper-limb motor impairment. No trials reported adverse effects.


CONCLUSIONS
There is evidence that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Harris
Jocelyn E
JE
Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
Eng
Janice J
JJ
D001132:Arm / Q000502:physiology*; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D020127:Recovery of Function / Q000502:physiology*; D055070:Resistance Training / Q000379:methods*; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D034941:Upper Extremity / Q000502:physiology