title: Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial.
abstract: To evaluate the effects of progressive resistance and balance (PRB) exercises on physical and psychological functions of post-stroke individuals.
  
  
  
  In a randomized controlled trial with follow-up at 3, 6 and 15 months, 67 community-living individuals (76% male; 65-85 years) with a stroke 1-3 years previously were allocated to an intervention group (IG, n = 34; PRB exercises combined with motivational group discussions twice weekly for 3 months) or a control group (CG, n = 33). The primary outcomes were balance (Berg Balance Scale, 0-56 points) and mobility (Short Physical Performance Battery, 0-12 points) at 3 months. The secondary outcomes were 10 m comfortable walking speed, physical activity levels, health-related quality of life, depression and fall-related self-efficacy.
  
  
  
  At 3 months, the IG exhibited significant improvements in balance (MD 2.5 versus 0 points; effect size [ES], 0.72; p < 0.01) and comfortable walking speed (MD 0.04 versus -0.05 m/s; ES, 0.68; p = 0.01) relative to the CG. A faster walking speed persisted at 6 months. No differences were found for the other outcomes.
  
  
  
  In chronic stroke patients, 3 months of PRB exercises and motivational discussions induced improvements in balance at 3 months and in walking speed at 3 and 6 months. Implications for Rehabilitation A progressive resistance and balance exercise program supported by motivational group discussions and one home-based exercise appears to be an effective means of improving the short-term balance and the walking speed in individuals with chronic stroke. People with poor balance and motor function discontinued the study more often and may require additional support. There is a need for powerful and cost-effective strategies that target changes in behavior to obtain long-term changes in physical function after exercising.
authors.affiliation: a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Birgit
authors.initials: B
authors.lastname: Vahlberg
authors.affiliation: b Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.affiliation: a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Lindmark
authors.affiliation: a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Zetterberg
authors.affiliation: a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance; D011788:Quality of Life; D055070:Resistance Training; D020377:Self Efficacy; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D013548:Sweden; D013995:Time; D000072797:Walking Speed
keywords: Depression; health-related quality of life; high-intensity functional exercise; self-related self-efficacy; walking