%0 Journal Article
%T Gait Performance and Lower-Limb Muscle Strength Improved in Both Upper-Limb and Lower-Limb Isokinetic Training Programs in Individuals with Chronic Stroke
%A Marie-H¨Śl¨¨ne Milot
%A Sylvie Nadeau
%A Denis Gravel
%A Daniel Bourbonnais
%J ISRN Rehabilitation
%D 2013
%R 10.1155/2013/929758
%X Background. Limited improvement in gait performance has been noted after training despite a significant increase in strength of the affected lower-limb muscles after stroke. A mismatch between the training program and the requirements of gait could explain this finding. Objective. To compare the impact of a training program, matching the requirements of the muscle groups involved in the energy generation of gait, to a control intervention, on gait performance and strength. Methods. 30 individuals with chronic stroke 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, while the control group trained the upper-limb muscles. Baseline and posttraining values of gait speed, positive power (musclesĄŻ concentric action during gait), and strength were retained and compared between groups. Results. After training, both groups showed a similar and significant increase in gait speed, positive power of the hip muscles, and plantarflexors strength. Conclusion. A training program targeting the lower-limb muscles involved in the energy generation of gait did not lead to a greater improvement in gait performance and strength than a training program of the upper-limb muscles. Attending the training sessions might have been a sufficient stimulus to generate gains in the control group. 1. Introduction It is well recognized that residual muscle strength on the affected side secondary to a stroke has a great impact on activities of daily living, especially on gait performance. The self-selected and maximal gait speeds of individuals with stroke have been positively related to the residual strength of the affected plantarflexors [1¨C3], hip flexors [1¨C3], knee extensors, and flexors [1, 2]. Gait asymmetry has also been negatively related to the residual strength of various muscle groups including the plantarflexors and the knee extensors [1]. Knowing that muscle weakness can jeopardize the fulfillment of a functional gait in individuals with stroke, muscle strengthening of the affected lower-limb has become a recognized therapy in the field of rehabilitation. Many studies have verified the impact of resistance-strengthening programs on the muscle strength of the affected lower extremity of chronic individuals who have had a stroke (>3 months after stroke). Static, dynamic or isokinetic training protocols applied for less than three months resulted in a mean strength increase ranging from 7% to 155% and, generally speaking, this increase was
%U http://www.hindawi.com/journals/isrn.rehabilitation/2013/929758/