The Acute Effects of Muscle Power Training on Short-Term Functional Mobility in Patients Post-Stroke: A Case Series

John Jacob Evanich, Rachelle Studer-Byrnes

Abstract


Background and Purpose: Stroke is the leading cause of disability in the United States, but there is a lack of therapeutic exercise guidelines available for this patient population. Studies focusing on creating exercise protocols to improve lower extremity muscular power generation for these patients have demonstrated improvements in gait speed. Our purpose was to evaluate acute changes in gait speed and functional mobility following strength and power exercise protocols for patients post-stroke.  Measures: The following outcome measures were conducted to track change in gait speed and functional mobility with strength and power training: 10 Meter Walk Test, Five Time Sit to Stand, Timed Up and Go Test, and ascending a flight of 18 stairs for all three patients and the Functional Gait Assessment for two patients. Minimal detectable change (MDC) was used to determine if a real change occurred in outcome measure scores following each stage of the exercise protocol.  Interventions: Three patients post-stroke with decreased ambulatory abilities, including use of an assistive device and decreased ambulatory speed, completed a 4 week exercise protocol consisting of 2 weeks of muscular strength training and 2 weeks of muscular power training.  Outcomes: A positive change was observed in all 14 variables evaluated following power training, with 11 of 14 variables exceeding the MDC. A positive change was observed in 6 of 14 variables following week 1 of strength training with 2 exceeding the MDC, and a positive change was observed in 5 of 14 variables following week 2 of strength training with 1 exceeding the MDC.  Conclusion: Physical therapy rehabilitation programs with an emphasis on power training may cause greater acute improvements in gait speed and functional mobility when compared to strength training for the poststroke patient population.

Key Words: stroke, strength training, gait speed


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