The Effects of Upper Extremity Isokinetic Strengthening in Post-Stroke Hemiplegia: A Randomized Controlled Trial

Objective The aim of this study was to evaluate the efficacy of isokinetic strengthening in paretic upper extremity among patients with post-stroke hemiplegia. Methods Hemiplegic patients with at least 6 months post-stroke and those with arm and hand Brunnstrom motor recovery stage ≥ 3 were included to the study. Patients were randomized into two groups. Isokinetic training group received 4 weeks (3 days/week) of isokinetic strengthening, while the control group was tailored strengthening exercises with exercise bands. Outcome measures were the isokinetic peak torque of wrist flexor and extensors, Fugl-Meyer Assessment of upper extremity, Stroke Impact Scale (SIS), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, hand grip strength, peak isometric strength of wrist flexor and extensors. Outcome measures were evaluated before treatment, after treatment (at the end of week 4) and 4 weeks after the end of treatment (at the end of week 8). The trial was registered at ClinicalTtrials.gov (ID: NCT03834311). Results After 4 weeks, changes in extensor peak torque at 60°/sn (p=0.007) and extensor peak isometric muscle strength (p=0.007) were higher in the isokinetic group (n=12) than those in the control group (n=12). At the end of week 8, only DASH score revealed a significantly higher improvement in the isokinetic group than that in the control group (p=0.014). Conclusions Isokinetic strengthening may provide motor and functional improvement in paretic upper extremity among patients with post-stroke hemiplegia.