Article

OBJECTIVE: To investigate whether elastic resistance training can induce
comparable levels of muscle activity as conventional machine training in patients
with chronic stroke. DESIGN: Comparative study.
SETTING: Outpatient
rehabilitation facility. PARTICIPANTS: Stroke patients (N=18) with hemiparesis
(mean age, 57+/-8y). INTERVENTIONS: Patients performed 3 consecutive repetitions
at 10 repetition maximum of unilateral knee extension and flexion using elastic
resistance and conventional machine training. MAIN OUTCOME MEASURES: Surface
electromyography was measured in vastus lateralis, vastus medialis, biceps
femoris, and semitendinosus and was normalized to maximal electromyography (% of
max) of the nonparetic leg. RESULTS: In the paretic leg, agonist muscle activity
ranged from 18% to 24% normalized electromyography (% of max) (nEMG) during knee
flexion and from 32% to 40% nEMG during knee extension. For knee extension,
vastus lateralis nEMG was higher during machine exercise than during elastic
resistance exercise (40% [95% confidence interval {CI}, 33-47] vs 32% [95% CI,
25-39]; P=.003). In the nonparetic leg, agonist muscle activity ranged from 54%
to 61% during knee flexion and from 52% to 68% during knee extension. For knee
flexion semitendinosus nEMG was higher (61% [95% CI, 50-71] vs 54% [95% CI,
44-64]; P=.016) and for knee extension vastus medialis nEMG was higher (68% [95%
CI, 60-76] vs 56% [95% CI, 48-64]; P<.001) during machine exercise than during
elastic resistance exercise. By contrast, antagonist coactivation was
significantly higher during knee flexion when performed using elastic resistance
compared with the machine. Lastly, there were no differences in perceived
exertion between exercise modalities. CONCLUSIONS: Machine training appears to
induce slightly higher levels of muscle activity in some of the investigated
muscles compared to elastic resistance during lower limb strength training in
patients with chronic stroke. The higher level of coactivation during knee
flexion when performed using elastic resistance suggests that elastic resistance
exercises are more difficult to perform. This is likely due to a higher level of
movement instability.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS