Recovery of submaximal upper limb force production is correlated with better arm position control and motor impairment early after a stroke.

OBJECTIVE: This study determined whether recovery of upper limb position control using submaximal force production correlates with an improvement in functional arm impairment during early recovery from stroke. METHODS: Ten consecutive inpatients were recruited from a stroke unit. Each patient was in early recovery (<8 weeks post-lesion) from their first ever stroke. Evaluations of submaximal continuous force production and position control, maximal force production at the shoulder and a clinical outcome measure of motor impairment (Fugl-Meyer score; FM) were performed 20 days post-stroke as a baseline and then once a week for the following four weeks. RESULTS: Submaximal force production and its modulation during a position-holding task improved in early recovery after stroke, whereas maximal force production did not. Better modulation of submaximal force production enabled improved arm position control which was significantly correlated to the changes in FM score of motor impairment during recovery. CONCLUSIONS: This study demonstrated that improvement in submaximal force modulation can operate as a mechanism enabling better motor behaviour such as arm position control during early recovery from a stroke. SIGNIFICANCE: Future rehabilitation strategies may benefit from adding submaximal force development and modulation to early interventions after stroke.

Effects of lower limb reciprocal pedalling exercise on motor function after stroke: a systematic review of randomized and nonrandomized studies.

This review systematically synthesized current evidence on the effects of lower limb reciprocal pedalling exercise on motor function poststroke. Detailed analysis of single studies in the review revealed multiple instances of heterogeneity including outcome measures; therefore we decided to avoid undertaking a single, potentially misleading meta-analysis. We found that despite beneficial (although nondefinitive) effects on balance, functional independence, and muscle strength, it is not possible to make clinical recommendations that support or refute the use of reciprocal pedalling exercise to enhance recovery of motor function after stroke. Our findings provide proof-of-concept for pedalling interventions and provide a foundation for subsequent research, suggesting a need for further standardized, controlled clinical trials of clearly described pedalling interventions for stroke survivors and with subsequent transparent reported findings.