‍Purpose 

Chronic stroke patients often experience a variety of detrimental neuromuscular and cognitive changes. The variable resistance and eccentric loading offered by flywheel training may be useful for counteracting these effects in a safe and efficient manner. Following a promising pilot study from a couple years prior, the purpose of this study was to investigate the effects of flywheel training on various neuromuscular, functional, and cognitive measures in individuals with chronic stroke.  

Methods 

32 individuals that were at least 6 months post-stroke were randomly assigned to either a flywheel training group (n=16) or control group (n=16) that continued normal daily activities. The flywheel training group completed two flywheel training sessions per week for 12 weeks. Each session included 4 sets of 7 reps of unilateral leg press using the leg more affected by their stroke. Measures of muscle size, neuromuscular performance, functional performance (balance, gait, dual-task performance), spasticity, and several cognitive assessments were completed before and after the training intervention.    

Results 

The flywheel training experienced a variety of neuromuscular and functional improvements including improvements in quadriceps muscle size, muscle force and power, balance, gait, and dual-task performance. They also had significant improvements in measures of attention, working memory, speed of information processing, and executive functions. The control group did not have significant changes in any measure from pre to post.  

Key Takeaways 

• A low-volume flywheel program was effective for improving measures of neuromuscular, functional, and cognitive performance without any evidence of side effects or increased spasticity.  

• The neuromuscular benefits seen in this study were achieved with much lower volume than in previous studies that used traditional resistance training methods. This suggests flywheel training could be a particularly efficient method for counteracting neuromuscular impairments post-stroke.   

• Improvements in neuromuscular performance also occurred in the leg that did not perform flywheel training, which is known as “cross-education.” This benefit is thought to be due to the unique neural responses that occur to eccentric training. 

• Overall, flywheel training may be a safe, efficient, and effective method for counteracting the negative neuromuscular, functional, and cognitive changes that occur after experiencing a stroke.