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2 results on '"POSTSTROKE HEMIPLEGIA"'

1. MUSCLE TORQUE PRODUCTION AND KINEMATIC PROPERTIES IN POST-STROKE PATIENTS: A PILOT CROSS-SECTIONAL STUDY.

Author

Kowal, Mateusz, Kołcz, Anna, Dymarek, Robert, Paprocka-Borowicz, Małgorzata, and Gnus, Jan

Subjects
*WALKING speed, *TORQUE, *FLEXOR muscles, *CROSS-sectional method, *BARTHEL Index, *PILOT projects
Abstract

Purpose: Stroke-related hemiplegia is an important factor influencing parameters of gait. So far, limited papers have assessed temporo-spatial capabilities and their correlations with gait parameters in the early post-stroke stage. This pilot study evaluated the temporo-spatial parameters of gait and assessed the maximal isometric and isokinetic torque production of the plantar flexor and dorsiflexor muscles. Methods: 15 patients with lower limb spasticity and 15 healthy controls were included. Stroke severity was assessed using the Modified Ashworth Scale and the Barthel Index. Gait cadence, gait speed, and gait cycle were assessed using inertial sensors during a Timed Up and Go test. Maximal isometric and isokinetic torque production of the ankle plantar flexor and dorsiflexor muscles were assessed using an isokinetic dynamometer device. Results: Post-stroke patients had statistically significantly lower gait cadence than healthy participants (17%, p<0.05). Statistically significantly lower values of vertical acceleration were also noted during a sit-to-stand movement task (42%, p<0.05). Plantar flexion torque of the affected limb was significantly different during isometric (63%, p≤0.01) and isokinetic work for 30°/s (49%, p=0.04), 60°/s (58%, p=0.01) and 120°/s (53%, p=0.01). Dorsiflexor muscles' torque production was significantly different in isometric activity (38%, p=0.04). A statistically significant positive correlation occurred between the absolute peak torque of the dorsiflexor muscles in both static and speed phases of gait (rs=0.65, p=0.04). Conclusions: Despite the low intensity of spasticity and early phase after stroke, differences in the muscle torque production and temporo-spatial parameters, as well as the correlations between them, were noticeable. [ABSTRACT FROM AUTHOR]

Published
2020
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2. Effects of exercise training programs on walking competency after stroke - A systematic review

Subjects
exercise therapy, STANDING BALANCE, SUBACUTE STROKE, ENERGY-EXPENDITURE, RANDOMIZED CONTROLLED-TRIAL, IMPROVES WALKING, systematic review, POST STROKE, gait-related activities, GAIT OUTCOMES, PHYSICAL-THERAPY, cerebrovascular diseases, CARDIOVASCULAR FITNESS, POSTSTROKE HEMIPLEGIA
Abstract

To determine the effectiveness of training programs that focus on lower-limb strengthening, cardiorespiratory fitness, or gait-oriented tasks in improving gait, gait-related activities, and health-related quality of life after stroke. Randomized controlled trials (RCTs) were searched for in the databases of Pubmed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, DARE, Physiotherapy Evidence Database (PEDro), EMBASE, Database of the Dutch Institute of Allied Health Care, and CINAHL. Databases were systematically searched by two independent researchers. The following inclusion criteria were applied: (1) participants were people with stroke, older than 18 yrs; (2) one of the outcomes focused on gait-related activities; (3) the studies evaluated the effectiveness of therapy programs focusing on lower-limb strengthening, cardio respiratory fitness, or gait-oriented training; and (4) the study was published in English, German, or Dutch. Studies were collected up to November 2005, and their methodological quality was assessed using the PEDro scale. Studies were pooled and summarized effect sizes were calculated. Best-evidence synthesis was applied if pooling was impossible. Twenty-one RCTs were in-of which five focused on lower-limb strengthening, two on cardiorespiratory, fitness training (e.g., cycling exercises), and 14 on gait-oriented training. Median PEDro, score was 7. Meta-analysis showed a significant medium effect of gait-oriented training interventions on both gait speed and walking distance, whereas a small, nonsignificant effect size was found on balance, Cardiorespiratory fitness programs had a nonsignificant medium effect size on gait speed. No significant effects were found for programs targeting lower-limb strengthening. In the best-evidence synthesis, strong evidence was found to support cardiorespiratory training for stair-climbing performance. Although functional mobility was positively affected, no evidence was found that activities of daily living, instrumental activities of daily living, or health-related quality of life were significantly affected by gait-oriented training. This review shows that gait-oriented training is effective in improving walking competency after stroke.

Published
2007

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