# The role of strength training in rehabilitation – What does research say? > The benefits of strength training are wide-ranging, from pain relief to enhanced strength and overall function. But what does the research evidence say? ## 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 Evidence for Strength Training 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). ## Methodology and Evidence Assessment This article is part of a series produced in the Professional in Physiotherapy course at Savonia University of Applied Sciences. Students practice elements of a systematic literature review, including systematic information retrieval, critical appraisal using the PEDro Scale tool, and writing up results. 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 (De Morton 2009). For this review, a comprehensive literature search was conducted on PubMed to identify studies involving adults aged 18 to 75 dealing with musculoskeletal issues or dysfunctions. Search terms included ‘’strength training’’, ‘’rehabilitation’’ and ‘’versus’’. ## Key Research Findings Recent studies highlight the significant role of strength training in improving pain and functional outcomes: * **Patellofemoral pain syndrome:** Raju et al. (2024) 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. * **Subacromial pain syndrome:** Karabay et al. (2024) examined eccentric versus concentric strengthening. While both reduced pain and improved function, eccentric strengthening demonstrated more significant benefits in pain management and shoulder function. * **Stroke recovery:** Shao et al. (2023) 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. ## Discussion and Variables Across these studies, strength training consistently emerged as an effective intervention. However, several variables influence results, including: * Rest periods between sets. * Frequency of the exercise regimen. * Emphasis on the eccentric phase of movement. These variations highlight the importance of standardizing exercise protocols to ensure consistency and reliability in future research. ## 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 ## References * De Morton, N. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. [PubMed](https://pubmed.ncbi.nlm.nih.gov/19463084/#full-view-affiliation-1). * 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. [DOI](https://doi.org/10.1177/19417381241236817). * Kauranen, K. 2011. *Motoriikan säätely ja motorinen oppiminen*. Liikuntatieteellisen Seuran julkaisunro 167. Tampere: Tammerprint Oy. * 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. [DOI](https://doi.org/10.3390/jpm14121130). * Raju, A., Jayaraman, K., Nuhmani, S., Sebastian, S., Khan, M., & Alghadir, A. H. (2024). Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial. *Medicine (Baltimore)*, 103(7). [DOI](https://doi.org/10.1097/MD.0000000000037102). * 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. [DOI](https://doi.org/10.1016/j.apmr.2022.09.012). * Tapio, J. & Vilén, V. (2020). *Fysioterapia 2.0. Kuntoutuksen tiede ja taide*. Lahti: VK-Kustannus Oy. * UKK-instituutti. Lihasvoima ja lihaskestävyys. [Online publication](https://ukkinstituutti.fi/fyysinen-kunto/kunnon-osa-alueet/lihasvoima-ja-lihaskestavyys/).