Effects of Task-Specific Locomotor and Strength Training in Adults Who Were Ambulatory After Stroke: Results of the STEPS Randomized Clinical Trial

Katherine J Sullivan, David A Brown, Tara Klassen, Sara Mulroy, Tingting Ge, Stanley P Azen, Carolee J Winstein for the Physical Therapy Clinical Research Network

This study was conducted to determine the effects of combined task-specific and lower-extremity (LE) strength training to improve walking ability after stroke.  80 adults who were ambulatory 4 months to 5 years after a unilateral stroke underwent a pair of exercise interventions from body-weight–supported treadmill training (BWSTT), limb-loaded resistive leg cycling (CYCLE), LE muscle-specific progressive-resistive exercise (LE-EX), and upper-extremity ergometry (UE-EX). Exercise sessions were 4 times per week for 6 weeks with exercise type completed on alternate days. The BWSTT/UE-EX group had significantly greater walking speed increases compared with the CYCLE/UE-EX group; both groups improved in distance walked. All BWSTT groups increased walking speed and distance whether BWSTT was combined with LE strength training or not.

After chronic stroke, task-specific training during treadmill walking with body-weight support is more effective in improving walking speed and maintaining these gains at 6 months than resisted leg cycling alone and clinicians should be aware that LE strength training alternated daily with BWSTT walking did not provide an added benefit to walking outcomes.

Physical Therapy, 2007, 87(12), 1580-1602

Link to Abstract

Targeted hip and knee strengthening

A short online course by Lee Herrington covering the principles of muscle reloading and strengthening for lower limb following injury.