title: Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial.
abstract: METHODS
  Within-participant randomised controlled trial.
  
  
  OBJECTIVE
  To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone.
  
  
  METHODS
  SCI units in Australia and India.
  
  
  METHODS
  Thirty people with recent SCI undergoing inpatient rehabilitation participated in this 12-week trial. One of the following muscle groups was selected as the target muscle group for each participant: the elbow flexors, elbow extensors, knee flexors or knee extensors. The target muscle on one side of the body was randomly allocated to the experimental group and the same muscle on the other side of the body was allocated to the control group. Strength training was administered to the experimental muscle but not to the control muscle. Participants were assessed at baseline and 12 weeks later. The primary outcome was maximal isometric muscle strength, and the secondary outcomes were spasticity, fatigue and participants' perception of function and strength.
  
  
  RESULTS
  There were no dropouts, and participants received 98% of the training sessions. The mean (95% confidence interval (CI)) between-group difference for isometric strength was 4.3 Nm (1.9-6.8) with a clinically meaningful treatment effect of 2.7 Nm. The mean (95% CI) between-group difference for spasticity was 0.03/5 points (-0.25 to 0.32).
  
  
  CONCLUSIONS
  Strength training increases strength in partially paralysed muscles of people with recent SCI, although it is not clear whether the size of the treatment effect is clinically meaningful. Strength training has no deleterious effects on spasticity.
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, C/O Royal North Shore Hospital, Pacific Hwy, St Leonards, New South Wales, Australia.|Physiotherapy Department, Spinal Injury Unit, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: E A
authors.initials: EA
authors.lastname: Bye
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, C/O Royal North Shore Hospital, Pacific Hwy, St Leonards, New South Wales, Australia.
authors.forename: L A
authors.initials: LA
authors.lastname: Harvey
authors.affiliation: Physiotherapy Department, Indian Spinal Injury Centre, Sector - C, Vasant Kunj, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Gambhir
authors.affiliation: Physiotherapy Department, Indian Spinal Injury Centre, Sector - C, Vasant Kunj, New Delhi, India.
authors.forename: C
authors.initials: C
authors.lastname: Kataria
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, C/O Royal North Shore Hospital, Pacific Hwy, St Leonards, New South Wales, Australia.
authors.forename: J V
authors.initials: JV
authors.lastname: Glinsky
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, C/O Royal North Shore Hospital, Pacific Hwy, St Leonards, New South Wales, Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Bowden
authors.affiliation: Physiotherapy Department, Indian Spinal Injury Centre, Sector - C, Vasant Kunj, New Delhi, India.
authors.forename: N
authors.initials: N
authors.lastname: Malik
authors.affiliation: Physiotherapy Department, Spinal Injury Unit, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: K E
authors.initials: KE
authors.lastname: Tranter
authors.affiliation: Physiotherapy Department, Spinal Injury Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
authors.forename: C P
authors.initials: CP
authors.lastname: Lam
authors.affiliation: Physiotherapy Department, Spinal Injury Unit, Royal Rehab, Ryde, New South Wales, Australia.
authors.forename: J S
authors.initials: JS
authors.lastname: White
authors.affiliation: Physiotherapy Department, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, Queensland, Australia.
authors.forename: E J
authors.initials: EJ
authors.lastname: Gollan
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, C/O Royal North Shore Hospital, Pacific Hwy, St Leonards, New South Wales, Australia.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-1024-3682
authors.initials: M
authors.lastname: Arora
authors.affiliation: Neuroscience Research Australia and University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Gandevia
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000503:physiopathology / Q000534:rehabilitation; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010243:Paralysis / Q000150:complications / Q000534:rehabilitation*; D055070:Resistance Training; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome