Ballistic Strength Training in Stroke: A Pilot Study
Ballistic Strength Training in Stroke: A Pilot Study
This pilot study intends to evaluate whether stroke patients can complete ballistic strength
 exercises for thirty minutes, three times per week over a six week training period in
 addition to their existing rehabilitation program.

 It will evaluate whether using ballistic training principles, is superior in improving
 mobility compared with usual care exercises to improve mobility and leg strength in stroke
 patients.

 In this study there will be 15 participants per group, a total of 30 participants. The
 control group will receive usual care consistent with existing rehabilitation practice and
 literature. The experimental group will perform task specific strength training in a
 ballistic fashion.
Research Aims:

 1. To establish the feasibility of ballistic strength training in stroke and

 2. To evaluate the effects of ballistic strength training exercises on mobility outcomes,
 strength and quality of life when compared with usual care.

 Methods:

 This wil be a prospective, randomized, controlled, assessor-blinded pilot study. It will be
 conducted 3 x per week for 6 weeks (i.e. a total of 18 sessions lasting 30 minutes).

 Primary outcome measure: Feasibility

 -  Recruitment

 -  Retention/Attrition

 -  Clinical Feasibility

 -  Safety

 Secondary outcome measures - measured at baseline and completion

 -  Ten metre walk test (10MWT) comfortable pace

 -  10MWT maximum safe pace

 -  High level mobility assessment tool (HiMAT): Only in participants where 10MWT is <12.5s
 at baseline

 -  Timed up and go test (TUG)

 -  Functional Ambulation Category (FAC)

 -  Health Related Quality of Life (HRQoL) via AQoL-4D

 Description of intervention:

 Control Group:

 The control group will complete a suite of exercises based upon existing rehabilitation
 practices that aim to improve mobility after stroke. The supervising physiotherapist will
 select and progress the exercises, recording the performance of exercises in an exercise log
 and detailing incidence of adverse events. Exercise selection will include: gait retraining,
 cardiovascular fitness, lower limb strengthening, static and dynamic balance

 Experimental group:

 The experimental group will complete jump squats on the leg sled, single leg toe push offs
 (or bilateral where unable to complete single), alternating legs (i.e. bounding), mini tramp
 jumping, progressing to jogging, quick hip flexion and bounding on land.
Inclusion Criteria:

 -  Inpatient at Caulfield Hospital Neurological Rehabilitation Unit at the time of
 recruitment

 -  Diagnosis of first stroke

 -  Presence of lower limb weakness determined by >10% difference in knee extensor
 strength between sides

 -  Functional Ambulation Category (FAC) > 3

 -  Can walk a minimal distance of 14 metres (to allow measurement on a 10metre walk test
 (10MWT)

 Participants who meet all the inclusion criteria except for their FAC score will have their
 FAC score re-measured on a weekly basis until they reach a score of greater than or equal
 to 3, at which point they become eligible and will be approached for recruitment.

 Exclusion Criteria:

 -  Unable to provide informed consent (determined by consultation with rehabilitation
 consultant and the team neuropsychologist)

 -  Other diagnosed central nervous system disorder affecting mobility

 -  Active oncological diagnosis

 -  Unstable medication condition such as unstable diabetes or unstable cardiac condition
 that would prevent participation in cardiovascular activity

 -  Recent orthopaedic trauma and/or osteoarthritis that would limit participation in
 physical exercise

 -  Not willing to continue to attend the program if they discharge home before the end of
 the six week program