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Figure 3 | Journal of NeuroEngineering and Rehabilitation

Figure 3

From: Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

Figure 3

Therapeutic interventions. The therapeutic interventions used in this study included functional task practice (FTP) and upper-extremity power training combined with FTP (HYBRID). The structure of the FTP program is outlined in Panel A with examples of how activities were identified for study participants of varying abilities and progressed over the course of the intervention. Power training was delivered using a commercially available dynamometer fitted with custom attachments to enable non-standard positioning and accommodate individuals with impaired grasp. Pictured in Panel B are configurations for elbow flexion/extension (top), shoulder abduction (middle) and shoulder external rotation. The elbow flexion/extension configuration was also used for stretch reflex testing. Power training involved 3 sets of 10 repetitions of each exercise: shoulder flexion, shoulder abduction, shoulder external rotation, elbow flexion/extension. The criterion speeds for each set were varied using the protocol illustrated in Panel C. The first set of each exercise involved eccentric actions in which the participant resisted the dynamometer through the full range of motion. Using data reported by Colsen et al[30] (see Figure1) to estimate the power produced (i.e., torque x velocity) per contraction, the program was systematically progressed by increasing workload by 44% (Sessions 5-8 relative to 1-4) and 84% (Sessions 9-12 relative to 1-4).

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