1. STRENGTH TRAINING

2. STRENGTH TRAINING AND CONDITIONING
Strength training had been discarded from many therapy programmes over
the past five decades due to certain beliefs.
1.Weakness – due to inhibition from spastic antagonist
2.Strength training increases spasticity , co-contraction and abnormal
movement patterns.
Clinical research has shown that effort applied in strength training does not
increase spasticity.

3. Does not increase spasticity
Improves functional performance
Increasing muscle compliance
Butefisch et al 1995
Davies et al 1996
Sharp and brouwer 1997
Miller and light 1997
Smith et al 1999
Salmela et al 1999
Otis et al
1985
Hummelsheim 1994

6. NO EVIDENCE- SPASTICITY INCREASES DUE TO STRENGTH TRAINING
SOME EVIDENCE- SPASTICITY DECREASES DUE TO STRENGTH TRAINING
NEURAL ADAPTATION
STRUCTURAL ADAPTATION
TYPES OF EXERCISES
OPEN CHAIN
CLOSE CHAIN

7. CONCENTRIC AND ECCENTRIC
Many research findings favour eccentric ex as it produces greater force than
concentric contractions,has greater mechanical efficiency,lesser metabolic energy
lesser muscular is needed for greater force.
ELICITING ACTIVITY OF WEAK MUSCLES
MRC partial body weight resistance or resistance through small ranges
MRC eccentric muscle activity
ES,EMG BIO FEEDBACK

8. Improved postural stability and reduction of falls in elderly
EFFECTS OF STRENGTHENING
Improved postural stability and reduction of falls in elderly
Increases muscle strength after stroke
Aniansson et al 1980,judge et al1993,
Tinetti et al1994,
Engardt et al1995,sharp et al 1997,duncan et al 1998.
Improved gait performance
Ability balance and stair climbing
Nakamura et al 1985,weiss et al 2000,krebs et al 1998.
Hamrin et al 1982,bohannon and walsh 1991

9. EXERXISE PRESCRIPTION
10 REP OF 50-80% OF THE MAXIMUM , 3 SETS , WITHOUT REST
BETWEEN EACH REPETITION
Body Weight,free weight,elastic bands,tread mill walking
Dosage is increased by increasing repetitions number of sets and load.
For endurance high repetitions are practiced at low levels of load
PHYSICAL CONDITIONING
5-10 min warm up [ stretching and ROM ex]
Aerobic ex [ graded walking ,stepping or cycling]
Strength training [hip , knee ankle flexors and extensors]

10. MAXIMIZING SKILL
PRESERVING MUSCLE LENGTH AND FLEXIBILITY