• Clinical rehabilitation · Sep 2009

    The effect of an intensive exercise programme on leg function in chronic stroke patients: a pilot study with one-year follow-up.

    • Roland Stock and Paul Jarle Mork.
    • Department of Physical Medicine and Rehabilitation, Munkvoll Rehabiliteringssenter, St Olavs Hospital, Trondheim, Human Movement Science Programme, Norwegian University of Science and Technology, Trondheim NO-7491, Norway.
    • Clin Rehabil. 2009 Sep 1; 23 (9): 790-9.

    ObjectiveTo investigate the effect of two weeks of intensive exercise on leg function in chronic stroke patients and to evaluate the feasibility of an intensive exercise programme in a group setting.DesignPilot study with one-group pre-test post-test design with two pre-tests and one-year follow-up.SettingInpatient rehabilitation hospital.SubjectsTwelve hemiparetic patients completed the intervention. Ten patients participated at one-year follow-up.InterventionSix hours of daily intensive exercise for two weeks with focus on weight-shifting towards the affected side and increased use of the affected extremity during functional activities. An insole with nubs in the shoe of the non-paretic limb was used to reinforce weight-shift toward the affected side.Main MeasuresTimed Up and Go, Four Square Step Test, gait velocity, gait symmetry and muscle strength in knee and ankle muscles.ResultsMaximal gait velocity (P = 0.002) and performance time (seconds) on Timed Up and Go (mean, SD; 12.2, 3.8 vs. 9.4, 3.2) and Four Square Step Test improved from pre- to post-test (P = 0.005). Improvements remained significant at follow-up. Preferred gait velocity and gait symmetry remained unchanged. Knee extensor (P<50.009) and flexor (P<50.001) strength increased bilaterally from pre- to post-test but only knee flexor strength remained significant at follow-up. Ankle dorsi flexor (P = 0.02) and plantar flexor (P<0.001) strength increased on paretic side only (not tested at follow-up).ConclusionIntensive exercise for lower extremity is feasible in a group setting and was effective in improving ambulatory function, maximal gait velocity and muscle strength in chronic stroke patients. Most improvements persisted at the one-year follow-up.

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