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.

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