Muscle strength and locomotion ability in individuals with chronic stroke

Authors

DOI:

https://doi.org/10.1590/1809-2950/18032126022019

Keywords:

Stroke, Muscle Strength, Locomotion

Abstract

The objective of this study was to verify if there are differences in the lower-limb muscle strength (LL) and in the locomotion ability among post-stroke patients classified as community or non-community ambulators. A cross-sectional study was conducted in 60 post-chronic stroke subjects, divided into community (n=33) and non-community (n=27) ambulators by gait speed. The muscle strength of seven bilateral muscle groups of LL was evaluated through the modified sphygmomanometer test and locomotion ability through ABILOCO. Descriptive statistics were used to characterize the sample, and Student’s t-test was used for independent samples to compare the two groups of post-stroke individuals. We observed that community ambulators had higher values of muscle strength for most muscle groups of LL (−0.973≥t≥3.189; p≤0.04), and in the locomotion ability (t=−2.841; p=0.006). Community ambulators showed higher LL muscle strength and better locomotion ability compared with non-community ambulators. Physiotherapeutic evaluation of post-stroke individuals should include, besides the measurement of LL muscle strength and its treatment, the measurement of the perception of locomotion ability to analyze the evolution of the patient and the efficacy of the therapeutic behavior.

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References

Dobkin BH. Rehabilitation after stroke. N Engl J Med.

;352(16):1677-84. doi: 10.1056/NEJMcp043511

Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery

of walking function in stroke patients: the Copenhagen stroke

study. Arch Phys Med Rehabil. 1995;76(1):27-32.

Lord SE, McPherson K, McNaughton HK, Rochester L, Weatherall

M. Community ambulation after stroke: how important and

obtainable is it and what measures appear predictive?

Arch Phys Med Rehabil. 2004;85(2):234-9. doi: 10.1016/j.

apmr.2003.05.002

Perry J, Garret M, Gronley JK, Mulroy SJ. Classification of walking

handicap in the stroke population. Stroke. 1995;26(6):982-9.

doi: 10.1161/str.26.6.982

Nadeau S, Arsenault AB, Gravel D, Bourbonnais D. Analysis

of the clinical factor determining natural and maximal gait

speeds in adults with a stroke. Am J Phys Med Rehabil.

;78(2):123-30.

Dorsch S, Ada L, Canning CG, Al-Zharani M, Dean C. The strength

of the ankle dorsiflexors has a significant contribution to walking

speed in people who can walk independently after stroke: an

observational study. Arch Phys Med Rehabil. 2012;93(6):1072-6.

doi: 10.1016/j.apmr.2012.01.005

Mentiplay BF, Adair B, Bower KJ, Williams G, Tole G, Clark RA.

Association between lower limb strength and gait velocity

following stroke: a systematic review. Brain Inj. 2015;29(4):409-

doi: 10.3109/02699052.2014.995231

van de Port IG, Kwakkel G, Lindeman E. Community

ambulation in patients with chronic stroke: how is it

related to gait speed? J Rehabil Med. 2008;40(1):23-7. doi:

doi.org/10.2340/16501977-0114

Lemmens RJM, Timmermans AAA, Janssen-Potten YJM,

Smeets RJEM, Seelen HAM. Valid and reliable instruments

for arm-hand assessment at ICF activity level in persons with

hemiplegia: a systematic review. BMC Neurol. 2012;12(21):1-17.

doi: 10.1186/1471-2377-12-21

Polese JC, Nascimento LR, Faria CDCM, Laurentino GEC, de

Paula FR, Teixeira-Salmela LF. Percepção de hemiplégicos

crônicos sobre o uso de dispositivos auxiliares na marcha.

Rev Panam Salud Publica. 2011;30(3):204-8. doi: 10.1590/

S1020-49892011000900003

Nascimento LR, Rocha GM, Teixeira-Salmela LF. Perceptions

of individual with stroke regarding the use of a cane for

walking: a qualitative study. J Body Mov Ther. 2019;23(1):166-70.

doi: 10.1016/j.jbmt.2018.02.001

Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O

mini-exame do estado mental em uma população geral:

impacto da escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7.

doi: 10.1590/S0004-282X1994000100001

Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards

CL. Responsiveness and predictability of gait speed and other

disability measures in acute stroke. Arch Phys Med Rehabil.

;82(9):1204-12. doi: 10.1053/apmr.2001.24907

Faria CD, Teixeira-Salmela LF, Neto MG, Paula FVR. Performancebased tests in subjects with stroke: outcome scores, reliability

and measurement errors. Clin Rehabil. 2012;26(5):460-9. doi:

1177/0269215511423849

Nascimento LR, Caetano LCG, Freitas DCMA, Morais TM, Polese

JC, Teixeira-Salmela LF. Different instructions during the tenmeter walking test determined significant increases in maximum

gait speed in individuals with chronic hemiparesis. Braz J Phys

Ther. 2012;16(2):122-7. doi: 10.1590/S1413-35552012005000008

Avelino PR, Faria-Fortini I, Basilio ML, Menezes KKP, Magalhães

LC, Teixeira-Salmela LF. Adaptação transcultural do ABILOCO:

uma medida de habilidade de locomoção, específica para

indivíduos pós-acidente vascular encefálico. Acta Fisiátr.

;23(4):161-5. doi: 10.5935/0104-7795.20160031

Avelino PR, Magalhães LC, Faria-Fortini I, Basilio ML, Menezes

KKP, Teixeira-Salmela LF. Cross-cultural validity of the

ABILOCO questionnaire for individuals with stroke, based

on Rasch analysis. Disabil Rehabil. 2018;40(11):1310-17. doi:

1080/09638288.2017.1284908

Caty GD, Arnould C, Stoquart GG, Thonnard JL, Lejeune

TM. ABILOCO: a rasch-built 13-Item questionnaire to assess

locomotion ability in stroke patients. Arch Phys Med Rehabil.

;89(2):284-90. doi: 10.1016/j.apmr.2007.08.155

Helewa A, Goldsmith CH, Smythe HA. The modified

sphygmomanometer-an instrument to measure muscle

strength: a validation study. J Chronic Dis. 1981;34(7):353-61.

doi: 10.1016/0021-9681(81)90073-4

Souza LA, Martins JC, Teixeira-Salmela LF, Lara EM, Moura

JB, Aguiar LT, et al. Validity and reliability of the modified

sphygmomanometer test to assess strength of the lower limbs

and trunk muscles after stroke. J Rehabil Med. 2014;46(7):620-8.

doi: 10.2340/16501977-1823

Aguiar LT, Lara LM, Martins JC, Teixeira-Salmela LF, Quintino

LF, Christo PP, et al. Modified sphygmomanometer for the

assessment of strength of the trunk, upper and lower limb

muscles in subjects with subacute stroke: reliability and validity.

Eur J Phys Rehabil Med. 2016;52(5):637-49.

Souza LAC, Martins JC, Moura JB, Teixeira-Salmela LF, Paula

FVR, Faria CDCM. Assessment of muscular strength with

the modified sphygmomanometer test: what is the best

method and source of outcome values? Braz J Phys Ther.

;18(2):191-200. doi: 10.1590/S1413-35552012005000149

Lee KB, Lim SH, Ko EH, Kim YS, Lee KS, Hwang BY.

Factors related to Community ambulation in patients with

chronic stroke. Top Stroke Rehabil. 2015;22(1):63-71. doi:

1179/1074935714Z.0000000001

Spink, MJ, Fotoohabadi MR, Menz RA. Foot and ankle strength

assessment using hand-held dynamometry: reliability and

age-related differences. Gerontology. 2010;56(2):525-32. doi:

1159/000264655

Muff G, Dufour S, Meyer A, Severac F, Fayret F, Geny B, et

al. Comparative assessment of knee extensor and flexor

muscle strength measured using a hand-held vs. isokinetic

dynamometer. J Phys Ther Sci. 2016;28(9):2445-51.

doi: 10.1589/jpts.28.2445

Organização Mundial da Saúde. Como usar a CIF: um manual

prático para a Classificação Internacional de Funcionalidade,

Incapacidade e Saúde (CIF). São Paulo: Edusp; 2003 [cited

Apr 22]. Available from: http://www.fsp.usp.br/cbcd/wpcontent/uploads/2015/11/Manual-Pra%CC%81tico-da-CIF.pdf

Sumsion T, Law M. A review of evidence on the conceptual

elements informing cliente-centred practice. Can J Occup Ther.

;73(3):153-62. doi: 10.1177/000841740607300303

Published

2023-02-27

Issue

Section

Original Research

How to Cite

Muscle strength and locomotion ability in individuals with chronic stroke. (2023). Fisioterapia E Pesquisa, 26(2), 158-163. https://doi.org/10.1590/1809-2950/18032126022019