Muscle,functional and cognitive adaptations after flywheel resistance training in stroke patients: A pilot randomized controlled trial

Background: resistance exercise (re) improves neuromuscular function and physical performance after stroke. yet,the effects of re emphasizing eccentric (ecc; lengthening) actions on muscle hypertrophy and cognitive function in stroke patients are currently unknown. thus,this study explored the effects of ecc-overload re training on skeletal muscle size and function,and cognitive performance in individuals with stroke. methods: thirty-two individuals with chronic stroke (≥6 months post-stroke) were randomly assigned into a training group (tg; n = 16) performing ecc-overload flywheel re of the more-affected lower limb (12 weeks,2 times/week; 4 sets of 7 maximal closed-chain knee extensions; <2 min of contractile activity per session) or a control group (cg; n = 16),maintaining daily routines. before and after the intervention,quadriceps femoris volume,maximal force and power for each leg were assessed,and functional and dual task performance,and cognitive functions were measured. results: quadriceps femoris volume of the more-affected leg increased by 9.4 % in tg. muscle power of the more-affected,trained (48.2 %),and the less-affected,untrained limb (28.1 %) increased after training. tg showed enhanced balance (8.9 %),gait performance (10.6 %),dual-task performance,executive functions (working memory,verbal fluency tasks),attention,and speed of information processing. cg showed no changes. conclusion: ecc-overload flywheel resistance exercise comprising 4 min of contractile activity per week offers a powerful aid to regain muscle mass and function,and functional performance in individuals with stroke. while the current intervention improved cognitive functions,the cause-effect relationship,if any,with the concomitant neuromuscular adaptations remains to be explored. © 2016 fernandez-gonzalo et al.