Weakness in Patients with Stroke: Implications for Strength Training in Neurorehabilitation

Muscle weakness is a significant consequence of stroke. Reduction of muscle strength is due to the combined effects of the upper motor neuron lesion and secondary adaptations due to denervation, disuse and inactivity and, in some individuals, the effects of aging. Strength training is not applied in stroke rehabilitation where it is believed that resisted activities will increase spasticity and therefore interfere with motor control. However, recent research provides evidence that muscle strength directly relates to functional performance and intensive strength training has been shown to be beneficial for improving strength and aspects of functional performance without exacerbating abnormal muscle activation. The research literature suggests that task-specific training including resisted strengthening exercises is an appropriate intervention to optimize the performance of functional activities following stroke by both increasing the force-generating capacity of muscles and by increasing skill.