Effects of resistance training and aerobic training on ambulation in chronic stroke.

Abstract

The aim of this study was to directly compare the effects of aerobic training (AT) with progressive resistance training (RT) after stroke to determine whether AT-induced fitness gains or RT-induced strength gains translate into improved ambulation across a 12-wk intervention and whether gains are retained 1 yr after cessation of formal training. This study is a randomized controlled 12-wk intervention trial with a 1-yr follow-up. Forty-three community-dwelling independent walkers with a chronic ischemic hemiparetic stroke were allocated to AT using a cycle ergometer (n = 13), RT using training machines (n = 14), or low-intensity sham training of the arms (n = 16). The main outcome measures were 6-min walk distance and fast 10-m walking speed. Comparisons between AT, RT, and sham training revealed no clinically relevant effects on walking velocity or walking distance. Muscle strength improved after RT (P < 0.0001) and was preserved at 1-yr follow-up (P < 0.001). Aerobic capacity increased after AT (P < 0.001) but was lost during the follow-up observation period. Improvement of muscle strength or aerobic capacity using non-task-specific training methods does not result in improved ambulation in patients with chronic stroke. Muscle strength gains were maintained at follow-up, whereas all improvements of aerobic capacity were lost, indicating a long-lasting effect of intensive RT even without maintenance training.