Introduction

Muscle tissue plays a vital role in many of the body’s functions, including enabling movement, maintaining posture, and facilitating various motions (Kauranen, 2011). Effective management of physical load requires a sufficient strength capacity, which underscores the importance of maintaining physical fitness and muscle strength (UKK-instituutti, 2023).

Strength training, which involves exercises where the body is challenged against external resistance, aims to improve muscle force production and induce positive adaptations in tissues responsible for generating force, such as muscles and tendons. This type of training has become a central element in physiotherapy for rehabilitating musculoskeletal conditions and injuries (Tapio & Vilén, 2020). The benefits of strength training are wide-ranging, from pain relief to enhanced strength and overall function. But what does the research evidence say?

Studies suggest that strength training not only strengthens muscles and supports joint function but also improves overall physical performance. Moreover, it has a positive impact on quality of life and daily functioning (Tapio & Vilén, 2020). In rehabilitation settings, strength training can be applied in various ways. For example, eccentric exercises (which involve lengthening muscle contractions) and concentric exercises (involving muscle shortening) may produce different outcomes, depending on the specific goals of the rehabilitation process.

It is essential to raise awareness about the significance of strength training, as many people may overlook its importance. Regular strength training often leads to better outcomes than relying solely on passive treatments, such as massages. Not only does strength training help improve physical performance, but it also provides long-term health benefits that cannot be achieved through passive treatments alone (Lim, Choi & Kim, 2024).

This article is part of a series produced in the Professional in Physiotherapy course, which is included in the physiotherapy degree program. The article was created as part of the evidence-based physiotherapy section of the course. In small groups, students practice elements of a systematic literature review, including systematic information retrieval, critical appraisal using the PEDro Scale tool, and writing up results in the form of a scientific article.

The PEDro scale (Physiotherapy Evidence Database) is a tool used to assess the quality of randomized controlled trials (RCTs) in physiotherapy research. It consists of 11 items that evaluate various aspects of study quality, including randomization, blinding, allocation concealment, and statistical analysis. The scale helps determine the internal validity of the trials and provides a clear, standardized method for assessing the methodological quality of evidence. (De Morton 2009).

The aim of this review was to explore the role of strength training in rehabilitation.

Methods

We conducted a comprehensive literature search on PubMed to identify studies that involved adults aged 18 to 75 who were dealing with musculoskeletal issues or dysfunctions. For search terms, we used ‘’strength training’’, ‘’rehabilitation’’ and ‘’versus’’. The studies included in our review focused on interventions using strength training programs aimed at improving muscle force and overall functional capacity. To assess the relative effectiveness of strength training, many of the studies compared it to conventional rehabilitation methods. The primary outcomes measured across the studies included improvements in strength, pain reduction, functional ability, and quality of life. By evaluating these factors, we sought to determine whether strength training offers superior benefits compared to traditional rehabilitation approaches for individuals with musculoskeletal conditions.

Results

Recent studies highlight the significant role of strength training in improving pain and functional outcomes across various musculoskeletal and neurological conditions. Raju et al. (2024) focused on patients with patellofemoral pain syndrome and found that adding hip abductor and external rotator strengthening to conventional physiotherapy yielded the greatest improvements in pain reduction and functional ability after four weeks of training. The group receiving combined strengthening exercises showed superior outcomes compared to those undergoing proprioceptive training or usual care.

Karabay et al. (2024) examined the effects of eccentric versus concentric strengthening in patients with subacromial pain syndrome. While both types of exercise reduced pain and improved function, eccentric strengthening demonstrated more significant benefits, particularly in pain management and shoulder function. This suggests that the type of strength training plays a crucial role in the effectiveness of rehabilitation.

Shao et al. (2023) investigated whether strengthening the non-affected side of the body could aid in the recovery of the hemiplegic side after a stroke. The study found that six weeks of non-paretic side strength training alongside traditional rehabilitation led to significant improvements in balance, walking ability, and muscle strength on the affected side. This underscores the value of strength training even in neurological rehabilitation.

Across all three studies, strength training consistently emerged as an effective intervention in improving both pain and functional outcomes. The studies suggest that the addition of targeted strengthening exercises—whether focused on specific muscle groups or on the non-affected side of the body—can enhance rehabilitation results. Notably, eccentric training and hip abductor strengthening seem to provide notable benefits for pain management and functional recovery. Furthermore, strength training’s potential extends beyond musculoskeletal conditions, as seen in Shao et al.’s (2023) stroke rehabilitation study, which emphasizes the role of strength training in neurological recovery. These findings support the inclusion of strength training as a key component in rehabilitation programs for various conditions, as it can provide superior benefits over conventional methods alone.

Conclusions

Strength training is a vital component of modern rehabilitation. It not only enhances muscle strength but also supports pain management, functional capacity, and quality of life. However, further long-term and large-scale studies are needed to better determine which types of training programs yield the best results across different patient populations.

When reviewing the studies, we observed that there are several potential variables that may influence the results. For example, the rest period between sets of exercises can vary significantly depending on the physiotherapist guiding the program. Additionally, the frequency with which the exercise regimen is carried out during the week might differ, depending on the recommendations or preferences of the physiotherapist.

Another notable factor is whether the physiotherapist emphasizes the eccentric phase of the movement, which may also lead to differences in the outcomes. These variations highlight the importance of standardizing certain aspects of exercise protocols to ensure consistency and reliability across studies.

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Authors:

Matias Ilvonen, physiotherapy student, Savonia University of Applied Sciences

Sulo Jäntti, physiotherapy student, Savonia University of Applied Sciences

Joonas Keijonen, physiotherapy student, Savonia University of Applied Sciences

Marja Äijö PT, PhD, Principal lecturer of Gerontology and Rehabilitation, Savonia University of Applied Sciences

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References:

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Karabay, D., Yeşilyaprak, S., Erduran, M., & Ozcan, C. (2024). Effects of eccentric versus concentric strengthening in patients with subacromial pain syndrome: A randomized controlled trial. Sports Health, 17(2), 322–331. https://doi.org/10.1177/19417381241236817. Referred to 1.10.2025.

Kauranen, K. 2011. Motoriikan säätely ja motorinen oppiminen. Liikuntatieteellisen Seuran julkaisunro 167. Tampere: Tammerprint Oy. Referred to 1.10.2025.

Lim, J., Choi, A., & Kim, B. (2024). The effects of resistance training on pain, strength, and function in osteoarthritis: Systematic review and meta-analysis. Journal of Clinical Medicine, 13(3), 876. https://doi.org/10.3390/jpm14121130. Referred to 1.10.2025.

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Shao, C., Wang, Y., Gou, H., Xiao, H., & Chen, T. (2023). Strength training of the nonhemiplegic side promotes motor function recovery in patients with stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 104(2), 188–194. https://doi.org/10.1016/j.apmr.2022.09.012. Referred to 1.10.2025.

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