Strength training for partially paralysed muscles in people with spinal cord injury

Abstract

The focus of this thesis is on strengthening of partially paralysed muscles following a spinal cord injury (SCI) with a particular emphasis on the effectiveness of different interventions. Weakness, as a result of partial paralysis is the most common and debilitating secondary impairment following a SCI. Therefore, physiotherapists spend a lot of time directing their interventions at increasing strength. The focus of this thesis is to further understand the effectiveness of these interventions and the mechanisms at play responsible for strength gains. This thesis includes four projects namely a randomised controlled trial (RCT), two pretest-posttest studies and a clinimetrics study. The findings of Project One and Two indicate that partially paralysed muscles do respond to strength training, however the underlying mechanisms behind these strength gains are not clear. Project Three indicated that strength training does not reduce IMF. This is in contrast to some studies in the able-bodied population. Lastly, Manual Muscle testing (MMT) may be an appropriate strength assessment tool for assessing strength in clinical trials.