Strength training for weakened hands, arms

Strength training improves hand grip and arm function in people who have suffered a stroke without causing increased muscle spasticity or pain.

Stroke commonly weakens muscles and may temporarily cause muscle spasm and pain. There is some controversy surrounding strength training in stroke patients, as some rehabilitation groups feel that strengthening stroke-weakened muscles may also increase spasticity and pain.

Researchers from Canada pooled results from 13 studies (with a total of 517 participants) that recorded how strength training exercises, versus no strengthening intervention, affected overall arm strength and function in 517 stroke patients with mild to moderately impaired movement of the upper limbs.

On average, it was found that strength training lasted for about one hour on 2 to 3 days a week for 4 weeks, although some of the training periods extended as long as 19 weeks. Most interventions used small weights, resistance bands, and gym-type pulley weights to build muscle. The combined results suggest that not only does strengthening not increase spasticity but may actually reduce it.

None of the studies analysed reported side effects, and those that measured spasticity prior to strength training reported no increase in spasticity over the course of training. In six studies (a total of 306 participants), strength training led to moderate or large improvement in hand grip strength. In 11 studies (a total of 465 participants) training resulted in a small improvement in arm function.

However, five studies involving 210 participants showed no improvement in activities of daily living, for example picking up a small object. This finding calls for a re-evaluation of stroke rehabilitation efforts to ensure that strength training not only improves function, but also activities of daily living.