title: Strength training associated with task-oriented training to enhance upper-limb motor function in elderly patients with mild impairment after stroke: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to verify the effects of loaded exercises associated with a task-oriented training (TOT) program in the recovery of upper-limb function in individuals with chronic hemiparesis after stroke.
  
  
  METHODS
  This study used a single-blinded, randomized controlled trial. Patients were included into two TOT groups: one that performed the task-oriented therapy without load (TOT group, n = 10) and another one that performed task-oriented therapy with personalized resistance (TOT_ST group, n = 10) for 6 wks, for a total of 12 sessions. Main measures included The Upper Extremity Performance Test, shoulder flexor and handgrip strength, shoulder active range of motion, motor impairment (Fugl-Meyer Scale), and muscle tone.
  
  
  RESULTS
  The TOT_ST group demonstrated better scores relating to unilateral tasks and in the quality aspects of bilateral movements (The Upper Extremity Performance Test, P = 0.04) at the end of rehabilitation protocol. The highest muscle force gain was reached by the TOT_ST group for the shoulder flexors (P = 0.001). Similarly, the active range of motion (P = 0.01) and Fugl-Meyer scores (P = 0.001) were higher in the TOT_ST group compared with the TOT group. Both groups showed improvement after training.
  
  
  CONCLUSIONS
  Strength training was able to intensify the upper-limb rehabilitation, as demonstrated by the superior scores achieved by the TOT_ST group in most of the evaluated parameters. Muscle strength training might be a pivotal element of the task-oriented rehabilitation program of chronic patients with mild impairment after stroke.
authors.affiliation: From the Programa de Pós-graduação em Ciências da Reabilitação (PBdS, FNA, FC, ASP), Departamento de Fisioterapia (PG, FC, ASP), and Programa de Pós Graduação em Ciências da Saúde (ASP), Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Paulo Bazile
authors.initials: PB
authors.lastname: da Silva
authors.forename: Fabiane Nunes
authors.initials: FN
authors.lastname: Antunes
authors.forename: Patrícia
authors.initials: P
authors.lastname: Graef
authors.forename: Fernanda
authors.initials: F
authors.lastname: Cechetti
authors.forename: Aline de Souza
authors.initials: Ade S
authors.lastname: Pagnussat
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*