Journal
TOPICS IN STROKE REHABILITATION
Volume 23, Issue 2, Pages 126-135Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10749357.2015.1112062
Keywords
Stroke; Rehabilitation; Cross-education; Unilateral strength training; Strength transfer
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Funding
- IT Sligo President's Bursary Fund
- Institutes of Technology Ireland Postgraduate Research Scholarship
- Lecturer at IT Sligo
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Background: Since its discovery in 1894 cross-education of strength - a bilateral adaptation after unilateral training - has been shown to be effective in the rehabilitation after one-sided orthopedic injuries. Limited knowledge exists on its application within the rehabilitation after stroke. This review examined the evidence regarding the implication of cross-education in the rehabilitation of the post-stroke hemiplegic patient and its role in motor function recovery. Methods: Electronic databases were searched by two independent assessors. Studies were included if they described interventions which examined the phenomenon of cross-education of strength from the less-affected to the more-affected side in stroke survivors. Study quality was assessed using the PEDro scale and the Cochrane risk of bias assessment tool. Results: Only two controlled trials met the eligibility criteria. The results of both studies show a clear trend towards cross-educational strength transfer in post-stroke hemiplegic patients with 31.4% and 45.5% strength increase in the untrained, more-affected dorsiflexor muscle. Results also suggest a possible translation of strength gains towards functional task improvements and motor recovery. Conclusion: Based on best evidence synthesis guidelines the combination of the results included in this review suggest at least a moderate level of evidence for the application of cross-education of strength in stroke rehabilitation. Following this review it is recommended that additional high quality randomized controlled trials are conducted to further support the findings.
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