Abstract
Objectives
The aim of the study was to investigate the relation of lower limb muscle strength
with normalized walking value, gait speed, and balance in patients with poststroke
hemiplegia.
Methods
Functional ambulatory unilateral hemiplegic patients were included in the study. Functionality
of the lower limb was tested by Fugl-Meyer lower extremity motor subscale. Six-minute
walk test (6MWT), 10-meter walk test, and Berg Balance Scale were performed to evaluate
functional walking capacity, gait speed, and balance, respectively. Normalized 6MWT
value was calculated by using a formula. Maximum isometric strengths of 8 muscle groups
of both limbs were measured using a handheld dynamometry and residual deficits of
the paretic side muscles were calculated.
Results
The study population was comprised of 61 hemiplegic patients (mean age: 54.6 ± 11.7
years and mean duration after stroke: 23.4 ± 18.1 months). Mean normalized walking
distance on 6MWT was 44.4% of expected. The residual deficits of the affected lower
extremity muscles were negatively correlated with normalized 6MWT: hip flexors (r = −.651),
hip extensors (r = −.621), hip abductors (r = −.657), hip adductors (r = −.630), knee
flexors (r = −.738), knee extensors (r = −.659), ankle dorsiflexors (r = −.776), and
ankle plantar flexors (r = −.773). Lower extremity residual deficits also showed moderate-strong
negative correlations with Berg Balance Scores and gait speed. Multiple linear regression
analyses showed that the residual deficits of the ankle plantar flexors and knee flexors
are the major independent determinants of normalized 6MWT results (R: .791 R2: 625).
Conclusions
Residual deficits of lower extremity muscles-particularly of ankle dorsiflexors, plantar
flexors, and knee flexors-are related to walking performance, gait speed and balance.
Besides, knee flexors and plantar flexors are predictors of normalized 6MWT.
Key Words
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Article info
Publication history
Published online: February 07, 2020
Accepted:
January 10,
2020
Received in revised form:
November 28,
2019
Received:
August 5,
2019
Footnotes
Funding: This study was supported by the Scientific Research Projects Unit of the Cukurova University (Project No: TTU-2015-4599).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104658
Copyright
© 2020 Elsevier Inc. All rights reserved.
