The results revealed that despite significant strength gains , many studies failed to show a significant improvement in walking capacity .
Strength testing and strengthening exercises were prioritized for the knee extensors and flexors , despite their relatively minor role in human walking .
Strengthening exercises performed in the neurologic population are not specific to the main muscle groups responsible for the power generation required for walking .
There is a predisposition for strength testing and strengthening exercises to focus on the knee flexors and extensors despite their relatively minor role during walking .
The aim of this systematic review was to investigate the task specificity of strength training programs for walking in neurologic rehabilitation .
Randomized clinical trial of therapeutic exercise in subacute stroke.
BACKGROUND AND PURPOSE Rehabilitation care after stroke is highly variable and increasingly shorter in duration . The effect of therapeutic exercise on impairments and functional limitations after stroke is not clear . The objective of this study was to determine whether a structured , progressive , physiologically based exercise program for subacute stroke produces gains greater than those attributable to spontaneous recovery and usual care . METHODS This r and omized , controlled , single-blind clinical trial was conducted in a metropolitan area and 17 participating healthcare institutions . We included persons with stroke who were living in the community . One hundred patients ( mean age , 70 years ; mean Orpington score , 3.4 ) consented and were r and omized from a screened sample of 582 . Ninety-two subjects completed the trial . Intervention was a structured , progressive , physiologically based , therapist-supervised , in-home program of thirty-six 90-minute sessions over 12 weeks targeting flexibility , strength , balance , endurance , and upper-extremity function . Main outcome measures were postintervention strength ( ankle and knee isometric peak torque , grip strength ) , upper- and lower-extremity motor control ( Fugl Meyer ) , balance ( Berg and functional reach ) , endurance ( peak aerobic capacity and exercise duration ) , upper-extremity function ( Wolf Motor Function Test ) , and mobility ( timed 10-m walk and 6-minute walk distance ) . RESULTS In the intention-to-treat multivariate analysis of variance testing the overall effect , the intervention produced greater gains than usual care ( Wilk 's lambda=0.64 , P=0.0056 ) . Both intervention and usual care groups improved in strength , balance , upper- and lower-extremity motor control , upper-extremity function , and gait velocity . Gains for the intervention group exceeded those in the usual care group in balance , endurance , peak aerobic capacity , and mobility . Upper-extremity gains exceeded those in the usual care group only in patients with higher baseline function . CONCLUSIONS This structured , progressive program of therapeutic exercise in persons who had completed acute rehabilitation services produced gains in endurance , balance , and mobility beyond those attributable to spontaneous recovery and usual care
The results revealed that despite significant strength gains , many studies failed to show a significant improvement in walking capacity .
Strength testing and strengthening exercises were prioritized for the knee extensors and flexors , despite their relatively minor role in human walking .
Strengthening exercises performed in the neurologic population are not specific to the main muscle groups responsible for the power generation required for walking .
There is a predisposition for strength testing and strengthening exercises to focus on the knee flexors and extensors despite their relatively minor role during walking .
The aim of this systematic review was to investigate the task specificity of strength training programs for walking in neurologic rehabilitation .