A comprehensive Cochrane review of 27 randomized controlled trials involving 1004 adults evaluated the effects of resistance training after stroke compared with non-exercise control conditions. The evidence showed that resistance training does not change mortality rates either at the end of intervention or during follow-up, with high-certainty findings. The impact on disability, blood pressure, and secondary cardiovascular events remains very uncertain, as these outcomes were reported in only a few small trials with wide confidence intervals.
Findings suggest that resistance training probably improves muscle strength in both legs and arms, particularly on the unaffected side, and may lead to small improvements in balance that may persist at follow-up. However, resistance training likely results in little or no improvement in walking speed, and follow-up evidence for longer-term retention of benefits is limited. Adherence was generally good, with no serious adverse events reported, though acceptability varied. Overall, more high-quality trials are needed to clarify long-term benefits and optimal training protocols.
Keywords: stroke rehabilitation, resistance training, muscle strength, physical function