Arm exercise improves walking ability after stroke

A new study shows that arm exercises may improve walking ability months and even years after having a stroke. The study tested the influence of arm training on post-stroke leg function.

Jose Rodriguez Jr. performs his daily exercises at home. Stacey Wescott, Chicago Tribune

Science Daily February 6, 2018

The study, the first to test the influence of arm training on post-stroke leg function, is published ahead of print in the Journal of Neurophysiology. It was chosen as an APSselect article for February.

Researchers from the University of Victoria in British Columbia, Canada, worked with a group of older adults who had had a stroke between 7 months and 17 years prior to the study. The volunteers participated in three 30-minute, moderate-intensity arm cycling training sessions each week for five weeks. The research team measured the volunteers’ physical abilities before and after arm training using several standardized scales and tests of physical function, including:

  • Six Minute Walk, which measures how far a person can walk in six minutes;
  • Timed 10 Meter Walk, which measures how quickly a person can walk 10 meters; and the
  • Timed Up and Go, which measures the time it takes to stand up from a seated position, walk 10 feet, turn around, walk back and sit down again.

The researchers also tested electrical activity in the muscles and stretch reflexes in the lower legs and wrists during both arm cycling and walking tests.

The participants improved their performance significantly on all of the walking tests — as much as 28 percent in the Timed Up and Go test. Several volunteers had less tightness in their muscles after completing the arm cycling trial, but there was no significant change in grip strength. Nerve activity increased during arm cycling as well. “Arm cycling training activated interlimb networks that contribute to the coordination of rhythmic walking,” the researchers wrote. In other words, nerves in the arms activated and adapted to improve function of the spinal cord in other areas of the body, such as the legs, affected by stroke.

These results could have a large impact on stroke rehabilitation, even years after injury. “Although improvements in walking may not be as robust as those from other training modalities, they do highlight the integral role that training the arms can have on rehabilitation of human locomotion,” the research team wrote.

Source Science Daily
via American Physiological Society (APS)

  References

Rhythmic arm cycling training improves walking and neurophysiological integrity in chronic stroke-the arms can give legs a helping hand in rehabilitation, Kaupp C, Pearcey GE, Klarner T, Sun Y, Barss TS, Cullen H, Zehr EP. J Neurophysiol. 2017 Dec 6. doi: 10.1152/jn.00570.2017. [Epub ahead of print]

  Further reading

Can Arm and Leg Cycling Exercise Improve Walking After Stroke, EP Zehr, University of Victoria. Dec 2014. Clinicaltrials.org

Meaningful change and responsiveness in common physical performance measures in older adults, Perera S, Mody SH, Woodman RC, Studenski SA. J Am Geriatr Soc. 2006 May;54(5):743-9.

Reliability of gait performance tests in men and women with hemiparesis after stroke, Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J. J Rehabil Med. 2005 Mar;37(2):75-82.

Reliability and validity of measures obtained from stroke patients using the Balance Master, Liston RA, Brouwer BJ. Arch Phys Med Rehabil. 1996 May;77(5):425-30.

Also see
Exercising arms improves post-stroke walking Lower Extremity Review
Exercise Aids in Stroke Recovery WebMD
The Best Exercises for Arm and Hands After Stroke Flint Rehab
Life after locked-in syndrome: Aurora man finds will to live after rare, paralyzing condition The Chicago Tribune
Neuroplasticity and How Movement Reshapes the Brain KineSophy
Black Belt Brain Blog – Musings on movement and the mind Psychology Today

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