Cerebrovascular accidents (CVA) often lead to disability and sometimes death due to lack of oxygen to different parts of the brain. These are also known more commonly as a “stroke,” and can cause weakness of the trunk and extremities, usually on the side opposite the brain damage. For example, a stroke affecting the left side of the brain will result in weakness to the right arm and leg.
Historically, resistance exercise was rarely used in stroke patients for fear of increasing muscle spasticity. Instead, rehabilitation focused on assisting with functional tasks and maintaining muscle range of motion. With the advances in stroke recognition and treatment, and the subsequent increase in those surviving a stroke, stroke survivors (estimated at 6 million survivors) are often left with residual weakness and functional disability. Therefore, strength training is now recommended for ambulatory stroke survivors.
A 2003 study using elastic resistance on stroke survivors was published by Dr. Pamela Duncan and colleagues. They found that a 12-week program including Thera-Band® resistance bands improved endurance, balance and mobility more than usual care after a subacute stroke. Their Thera-Band exercise protocol included exercises for the upper and lower extremities.
More recently, British researchers performed a 14-week physical therapy program for ambulatory stroke survivors 3 to 12 months after their stroke. The subjects had lower limb weakness but were able to walk with or without an assistive device. Their mean age was 65 years old. The patients performed the exercise program twice a week in a small group setting. They used cuff weights, resistance bands, and step-ups for resistance training of the lower extremities. Each session included a warm-up and cool-down. Participants exercised in sets of 10 repetitions over a 3-minute duration. When they were able to complete 50 repetitions in 3 minutes, the resistance was increased.
After the program, lower body strength significantly improved, as well as walking velocity and balance. Functional ability also significantly improved. Unfortunately, no control group was included in this study; therefore, it is not clear if these physical improvements were attributable to the exercise program or spontaneous recovery. Despite these limitations, this program has shown that Thera-Band products such as resistance bands and ankle and wrist weights can be used successfully in an exercise program for stroke survivors.
REFERENCE: Cramp MC, Greenwood RJ, Gill M, Lehmann A, Rothwell JC, Scott OM. Effectiveness of a community-based low intensity exercise programme for ambulatory stroke survivors. Disabil Rehabil. 2010;32(3):239-47.