The effectiveness of isokinetic strengthening in hemiplegic upper extremity

Objective: The aim of this study is to evaluate the effectiveness of isokinetic strengthening exercise on forearm muscles in patients with post-stroke hemiplegia. Method: Hemiplegic patients with at least 6 months post-stroke and those with upper limb and hand Brunnstrom motor recovery stage ≥ 3 were included to the study. Patients were randomized into two groups. Isokinetic exercise group received 4 weeks (3 days/week) of isokinetic training, whilst control group was tailored strengthening exercises with exercise bands for 4 weeks (3 days/week). Clinical and isokinetic outcome measures were evaluated before treatment, after treatment (4th week) and at 8th week. Outcome measures included the isokinetic peak torque, Fugl-Meyer Assessment of upper extremity, Stroke Impact Scale (SIS), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, peak isometric strength and hand grip strength. Results: The mean age of the study group (n=24; 7 females, 17 males) was 54.3±16.0 years. The isokinetic group (n=12) revealed significant improvements in all isokinetic extensor peak torque values and clinical parameters except for SIS subdomains of memory-thinking, communication and social participation. At 4th week, the changes in extensor peak isometric muscle strength (p=0.007) and extensor peak torque at 60°/sn (p=0.007) were significantly higher than those in the control group. At 8 th week, improvement in DASH score was significantly higher in the isokinetic group when compared to the control group (p=0.014). Conclusion: Isokinetic strengthening is an effective therapeutic method in terms of strengthening hemiparetic upper limb forearm muscles. Isokinetic strengthening can provide upper extremity motor and functional improvement in patients with chronic stroke. Keywords: Exercise, hemiplegia, isokinetic, rehabilitation, stroke.