Impact of Training on Gait and Strength in Stroke Survivors

Gait Performance and Lower-limb Muscle Strength Improved in Both Upper-limb and Lower-limb Isokinetic Training Programs in Individuals With Chronic Stroke

Background: A discrepancy between strength gain and gait changes following various training programs aimed at improving gait function after stroke has been noted. A mismatch between the training program and gait parameters could explain this finding. Objective: To evaluate the impact of an isokinetic-strengthening program, matching the requirements of the affected lower-limb muscle groups involved in the energy generation of gait, to a control intervention, on gait performance and muscle strength. Hypothesis: The isokinetic training program of the affected lower-limb muscles would produce greater changes in gait performance and strength than a control intervention not aiming at training these muscle groups. Design: Single-blinded randomized controlled trial. Participants: A convenient sample of 30 individuals with chronic hemiparesis. Interventions: Participants were randomly assigned into two groups (n=15), each training three times/week for six weeks. The experimental group trained the affected plantarflexors, hip flexors and extensors concentrically, while the control group trained the affected upper-limb muscles. Main outcome measures: Baseline values and post-training values, taken at the end of the training program, of maximal voluntary concentric strength, gait speed and peak positive power.

change in gait speed, in meter/second, was assessed as the difference between the baseline and week #7 values.

peak positive power was evaluated at the affected plantarflexors, hip flexors and hip extensors. Also, change in peak positive power, in weight/kilogram, was assessed as the difference between the baseline and week #7 values.

peak positive power was assessed at baseline and at the completion of the 6-week training (i.e. week #7)

maximal voluntary concentric strength was evaluated at the affected plantarflexors, hip flexors and hip extensors. Also, change in maximal voluntary concentric strength, in Newton-metre, was assessed as the difference between the baseline and week #7 values.

maximal voluntary concentric strength was assessed at baseline and at the completion of the 6-week training (i.e. week #7)

Inclusion Criteria: have a chronic (six months or more) unilateral stroke be able to walk 10 meters independently with or without a cane present residual weakness at the affected lower limb have an activity tolerance of at least two hours with a rest period Exclusion Criteria: receptive aphasia incontinence unstable medical condition history of injury anesthesia at the lower limbs