The Effect of Functional and Strengthening Exercises on Improvement of Upper Extremity Function in Patients with Hemiparesis Following Stroke

Background: Stroke is one of the most common life-threatening neurologic disorders and is
among the most important causes of disability in adult life. Disability of upper extremity is common
in hemiparetic patients following stroke. The purpose of this study was to determine the effects of
functional and strengthening exercises on joint range of motion, muscle strength and function of
involved upper extremity in hemiparetic patients after stroke.
Methods: In this double- blind randomized controlled trail, 28 hemiparetic patients aging
52.5±10.2 years with history of stroke at least 3 to 6 months ago, were recruited from Zahedan
rehabilitation clinics. Patients were randomly assigned to either a strengthening (n=14) or
functional (n=14) exercise group. Before and after 12 treatment sessions, upper extremity range of
motion (degree), muscle strength (Kg) and function (ordinal) were measured using goniometer,
dynamometer and River Mead Motor Assessment scale (RMA), respectively. For parametric data
independent and paired t-tests and for nonparametric data Mann-Whitney and Wilcoxon tests were
used to compare pretreatment and post treatment test results between groups and within them.
Results: The mean±SD of upper extremity function increased from 6.8±2.2 to 10.3±1.7 in the
functional exercise group and from 7.07±2.1 to 9±1.4 in the strengthening exercise group (p<0.05).
Also, the mean range of motion of shoulder, elbow and wrist joints and strength of upper extremity
muscles increased in both groups (p<0.05). After treatment, the mean upper extremity function was
greater in the functional exercise group than the strengthening one (p<0.05). However, no
significant difference was seen between two groups in measures of joint range of motion and muscle
strength of upper extremity (p>0.05).
Conclusion: Both the functional and strengthening exercises improve involved upper extremity
function, joint range of motion and muscle strength of upper extremity. However, in order to
improve upper extremity function, the functional exercises are more effective than other one.