“Task-Oriented” Exercise Improves Hamstring Strength and Spastic Reflexes in Chronic Stroke Patients

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Abstract
Background and Purpose —Despite the belief that after cerebral infarction only limited functional gains are possible beyond the subacute period, we tested the hypothesis that a 12-week program of “task-oriented” treadmill exercise would increase muscle strength and decrease spastic reflexes in chronic hemiparetic patients. Methods —Fourteen subjects, aged 66±3 (mean±SEM) years, with residual gait deviations due to remote stroke (>6 months), underwent repeated measures of reflexive and volitional (concentric and eccentric) torque with use of isokinetic dynamometry on the hamstring musculature bilaterally. Torque output was measured at 4 angular velocities (30 o , 60 o , 90 o , and 120 o /s). Results —After 3 months of 3 times/wk low-intensity aerobic exercise, there were significant main effects (2 legs [ P P P P P P P P P =0.45). Conclusions —These findings provide evidence that progressive treadmill aerobic exercise training improves volitional torque and torque/time generation and reduces reflexive torque/time production in the hemiparetic limb. Strength changes associated with improved functional mobility in chronic hemiparetic stroke survivors after treadmill training will be reported in future articles.