Effects of functional strength training in individuals with hemiplegia after stroke.

许多研究表明，力量训练对改善中风后偏瘫患者的运动功能具有重要意义。然而，目前还不清楚在这一人群中以任务为导向的训练是否可以增加他们的肌肉力量。首先，将三维步态分析测得的关节峰值扭矩与手持式测功机测得的同一关节的最大等长力进行了比较。结果表明，步行过程中髋伸肌群、膝屈肌群和趾屈肌群的关节峰值力矩均大于最大等长力。研究二采用随机对照试验，考察任务导向步态训练对肌肉强化的效果。这些结果表明，随着计时起搏试验的改进，在干预阶段，髋伸肌、膝屈肌和趾屈肌的最大等长力量都有所增加。递进耐力训练一般要求对靶肌肉进行超负荷训练。由于皮质脊髓束功能障碍，大部分中风患者不能进行强烈的肌肉收缩，自主肌肉收缩困难。任务导向步态训练具有替代力量训练增加肌肉力量的潜力。

Many studies suggested that strength training is important for improvement of motor function in individuals with hemiplegia after stroke. However, it is not clear whether a task oriented training to improve the walking in this population can increase their muscle strength. First study was conducted to compare between peak joint torque measured using 3D gait analysis and maximum isometric strength measured using hand-held dynamometer at same joint. The result revealed that peak joint torque during walking was higher than maximum isometric strength at hip extensor, knee flexor and plantarflexor muscles. Second study was conducted randomized control trial to examine the effects of task oriented gait training for muscle strengthening. These results showed maximum isometric strengths at hip extensor, knee flexor and plantarflexor muscles were increased during intervention phase with improvement of Timed Up and Go test. Generally, Progressive Resistance Training required the overload to the target muscle. Most of stroke patients can not perform the strong muscle contraction, because voluntary muscle contraction is difficult due to dysfunction of cortico-spinal tract. Task oriented gait training has a potential to increase the muscle strength instead of strength training.