Vol 51, No 3 (2017)

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Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation

Joanna Kostka1, Jan Czernicki2, Magdalena Pruszyńska3, Elżbieta Miller1
DOI: 10.1016/j.pjnns.2017.03.004
Neurol Neurochir Pol 2017;51(3):227-233.

Abstract

Objective

The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program.

Methods

Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (Fext, Fflex) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test.

Results

The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both Fflexkg−1 and Fextkg−1 had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for Fextkg−1 and, interestingly, even more prominent for Fflexkg−1.

Conclusions

MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors.

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