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Arch Phys Med Rehabil. 2016 Mar;97(3):429-36. doi: 10.1016/j.apmr.2015.10.099. Epub 2015 Nov 10.

Electromyographic Comparison of Elastic Resistance and Machine Exercises for High-Intensity Strength Training in Patients With Chronic Stroke.

Author information

1
National Research Centre for the Working Environment, Copenhagen Ø, Denmark.
2
National Research Centre for the Working Environment, Copenhagen Ø, Denmark; Prevention Health Exercise and Sport Research Group, Department of Physical Education and Sports, University of Valencia, Valencia, Spain.
3
National Research Centre for the Working Environment, Copenhagen Ø, Denmark; Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
4
Center for Rehabilitation of Brain Injury, University of Copenhagen, Copenhagen Ø, Denmark.
5
National Research Centre for the Working Environment, Copenhagen Ø, Denmark; Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. Electronic address: lla@nrcwe.dk.

Abstract

OBJECTIVE:

To investigate whether elastic resistance training can induce comparable levels of muscle activity as conventional machine training in patients with chronic stroke.

DESIGN:

Comparative study.

SETTING:

Outpatient rehabilitation facility.

PARTICIPANTS:

Stroke patients (N=18) with hemiparesis (mean age, 57 ± 8y).

INTERVENTIONS:

Patients performed 3 consecutive repetitions at 10 repetition maximum of unilateral knee extension and flexion using elastic resistance and conventional machine training.

MAIN OUTCOME MEASURES:

Surface electromyography was measured in vastus lateralis, vastus medialis, biceps femoris, and semitendinosus and was normalized to maximal electromyography (% of max) of the nonparetic leg.

RESULTS:

In the paretic leg, agonist muscle activity ranged from 18% to 24% normalized electromyography (% of max) (nEMG) during knee flexion and from 32% to 40% nEMG during knee extension. For knee extension, vastus lateralis nEMG was higher during machine exercise than during elastic resistance exercise (40% [95% confidence interval {CI}, 33-47] vs 32% [95% CI, 25-39]; P=.003). In the nonparetic leg, agonist muscle activity ranged from 54% to 61% during knee flexion and from 52% to 68% during knee extension. For knee flexion semitendinosus nEMG was higher (61% [95% CI, 50-71] vs 54% [95% CI, 44-64]; P=.016) and for knee extension vastus medialis nEMG was higher (68% [95% CI, 60-76] vs 56% [95% CI, 48-64]; P<.001) during machine exercise than during elastic resistance exercise. By contrast, antagonist coactivation was significantly higher during knee flexion when performed using elastic resistance compared with the machine. Lastly, there were no differences in perceived exertion between exercise modalities.

CONCLUSIONS:

Machine training appears to induce slightly higher levels of muscle activity in some of the investigated muscles compared to elastic resistance during lower limb strength training in patients with chronic stroke. The higher level of coactivation during knee flexion when performed using elastic resistance suggests that elastic resistance exercises are more difficult to perform. This is likely due to a higher level of movement instability.

KEYWORDS:

Electromyography; Physical therapy specialty; Rehabilitation; Resistance training; Stroke

PMID:
26558843
DOI:
10.1016/j.apmr.2015.10.099
[Indexed for MEDLINE]

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