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Can training of non-affected leg with eccentric overload technique improve muscle function, balance, walking ability and perceived participation in chronic stroke subjects?
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
2015 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]


Aim: The purpose of this study was to investigate effects of training of the non-affected leg with coupled concentric and eccentric contractions including brief episodes of eccentric overload on strength in the non-affected and affected leg as well as on balance, walking ability and perceived participation in chronic stroke subjects.

Methods: The design was an explorative experimental pilot study. Nine chronic stroke subjects (> 4 years post-stroke) performed eccentric overload training with non- affected leg, 2 times per week during 8 weeks. Peak power, isometric leg press force and training data were measured during all training session. Aspects of balance, gait and movement performance were assessed before and after the training period using Timed-up-and-go test, Bergs Balance scale, 30 sec chair-stand-test, 6-min walk test and Modified Ashworth scale. Stroke Impact Scale instrument was administered in order to assess some aspects of perceived participation.

Result: Peak power measured during training increased between session 1 and 16 for both concentric (12.7% p<0.001) and eccentric action (13.4% p<0.001) for the trained non-affected leg. Peak power in the affected leg increased for both concentric (22 % p=0.028) and eccentric action (38 % p=0.015). No significant changes were seen for isometric leg press force. Timed-up-and-go (14 % p=0.021), Berg balance test (3% p=0.026), 30 CST (24% p=0.020) all improved. No changes were seen on Modified Ashworth Scale, 6 minutes walk test or Stroke Impact Scale.

Conclusion: Training of the non-affected leg with eccentric overload technique in the flywheel leg press apparatus in chronic stroke subjects was safe and it improved concentric and eccentric peak power in both the affected and the non-affected leg, as well as balance, short-distance gait and functional leg strength. 

Abstract [sv]


Syfte: Syftet med denna studie var att undersöka om träning av det icke-paretiska benet med kombinerad koncentrisk och excentrisk träning som tillåter korta perioder av excentrisk överbelastning kan öka styrkan i det icke-paretiska och det paretiska benet samt förbättra balans, gångförmåga och upplevd delaktighet, hos kroniska strokepatienter.

Metod: Designen var en undersökande, experimentell pilot studie. Nio personer med stroke tränade i flywheel benpress 2ggr/v under 8 veckor. Peak power, isometrisk kraft och peak power mätt under varje träningspass användes för att utvärdera muskelfunktion. Timed up and go, Bergs Balansskala, 30 sek uppresningstest, 6 min gång test, Modified Ashworth scale och Stroke Impact Scale användes för att utvärdera funktionella aspekter samt upplevd delaktighet.

Resultat: Peak power ökade mellan träningspass 1 och 16 för både koncentrisk (12.7% p<0.001) och excentrisk (13.4% p<0.001) styrka. Peak power i det paretiska benet förbättrades koncentriskt (22 % p=0.028) och excentriskt (38 % p=0.015). Inga signifikanta skillnader observerades för isometrisk kraft i det paretiska eller icke- paretiska benet. Timed up and go (14 % p=0.021), Bergs balanstest (3% p=0.026) och 30-sek uppresningstest (24% p=0.020) förbättrades signifikant. Modified Ashworth Scale, 6-minuters gångtest eller Stroke Impact Scale uppvisade inga signifikanta förändringar.

Slutsats: Träning av det icke-paretiska benet med excentrisk överbelastningsteknik i flywheel benpress var säkert och förbättrade den koncentriska och excentriska styrkan såväl i det paretiska och som det icke-paretiska benet samt gav tydliga förbättringar med avseende på balans, kort-distans gång och funtionell benstyrka, hos strokepatienter lång tid (>4 år) efter insjuknandet. 

Place, publisher, year, edition, pages
2015. , 24 p.
Keyword [en]
Muscle strength, Stroke, Resistance training, Balance, Cross-education
National Category
URN: urn:nbn:se:umu:diva-105546OAI: diva2:826444
External cooperation
Region Jämtland Härjedalen
Educational program
Master's Programme in Physiotherapy
Available from: 2015-08-06 Created: 2015-06-25 Last updated: 2015-08-06Bibliographically approved

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