The Effects of Strengthening Exercises on Exaggerated Muscle Tonicity on the Chronic Hemiparesis Patients After Stroke

Stroke is one of the major causes of death and disability in every society. The disability resulting from stroke most commonly presents as hemiplegia or hemiparesis. The purpose of this study was to determine quadriceps and gasterosoleous muscles tonicity problems in hemiparetic patients, and the effects of strengthening exercises protocol on the treatment of these impairments due to the different critical opinions on the strengthening exercise's side effects. Thirty four hemiparetic patients secondary to stroke, mean age 52.4±6.2 years, participated in the study through simple non-probability sampling. All the patients were screened to ensure that the time passed since the onset of the stroke was at least 12 months. Patients were assigned randomly to either an experimental group or a control group. Muscle strength were measured using dynamometer and their muscle tone was graded on the modified Ashworth Scale before and after the 12 sessions of intervention. The experimental group received functional, balance and strengthening exercises (FBS) protocol. The control group received functional and balance exercises (FB) protocol. Independent and paired t-tests and Mann-Whitney and Wilcoxon tests were used for comparison between the pre-treatment and post-treatment results. The reduction of quadriceps tonicity only in the experimental group (p<0.0001) and gasterosoleous tonicity in both groups (experimental p<0.0001 & control p = 0.041) were significant after the intervention. Significant improvement after the treatment was seen in the experimental group in measures of quadriceps (p = 0.034) and gasterosoleous (p = 0.001) tonicity compared to the control group. The Mann-Whitney test identified a significant difference between the experimental group and the control group with respect to mean difference of quadriceps (p<0.0001) and gasterosoleous (p<0.0001) tonicity. The results of this study, in spite of conventional opinions, support the effectiveness of lower limb muscle strength training in reducing the spasticity, in addition to improving muscle strength in the chronic stages of rehabilitation following a stroke.