Strength After Stroke

Question 1

Describe NSF guidelines for strengthening after stroke

Answer 1

B - progressive resistance exercises (Gr 4-5)
B - ES (Gr 0-2)
C - electromyographic biofeedback

Question 2

Describe how ES facilitates strengthening

Answer 2

Increases central drive to mm
Improve activation capacity (%fibres activated with voluntary contraction)
Effective in bigger doses (60min daily) and when mm activated before ES

Question 3

Three characteristics of strengthening very weak muscles

Answer 3

Goal directed
High reps
Feedback system (activate mm themselves)

Decrease gravity, eliminate friction, change range, ecc contractions, reduce degrees of freedom, functional positioning

Question 4

How can we progress strength training

Answer 4

Incorporate coordination, inner range, sustained contractions, increase speed, add body weight resistance

Question 5

List causes of loss of strength after stroke

Answer 5

Neural - loss UMN (direct), loss LMN (indirect, transynaptic degeneration), decreased excitability, loss of orderly recruitment of motor units (fatigue causes fluctuations in strength)

Peripheral - loss of mm mass, motor units, remodeling of motor units (secondary disuse atrophy)