Effects of 6 Months Combined Functional Training on Muscle Strength, Postural Balance and Gait Performance in Community-dwelling Individuals with Chronic Stroke Hemiplegia

[Purpose] We conducted a noncontrolled intervention study in community-dwelling individuals with chronic stroke hemiplegia as subjects to examine the effectiveness of a 6 month low-frequency combined functional training program on enhancing factors related to physical performance, such as leg muscle strength, postural balance, and gait function. We also examined whether medium-term changes in physical performance correlated with time from stroke onset or degree of hemiplegia. [Subjects and Methods] Twenty-two individuals with chronic stroke hemiplegia who were using an adult day-care facility were enrolled in a combined functional training program consisting of stretching, muscle strengthening, postural balance training, and gait training once or twice a week for 6 months. The main outcomes measured were indices of physical performance - such as leg muscle strength (measured at about 1 repetition maximum [1RM] on a leg press machine), the functional reach test, the timed "up and go" test, comfortable gait speed, and maximum gait speed - and the Brunnstrom recovery stage (BRS). [Results] After 6 months of intervention, significant improvements were observed in all of the above-mentioned outcome measures of physical performance. No significant correlations were found between the percentage changes of physical performances after the intervention and time from stroke onset or BRS. [Conclusion] The 6 month low-frequency combined functional training program at an adult day-care facility results in medium-term improvements in leg muscle strength, postural balance and gait performance in community-dwelling individuals with chronic stroke hemiplegia.