title: Increased power generation in impaired lower extremities correlated with changes in walking speeds in sub-acute stroke patients.
abstract: BACKGROUND
  Establishing changes in net joint power in the lower extremity of patients during recovery of walking might direct gait training in early stroke rehabilitation. It is hypothesized that (1) net joint power in the lower extremity joints would increase in sub-acute stroke patients following gait rehabilitation, and (2) the improvements in net joint power would be significantly correlated with changes in walking speed.
  
  
  METHODS
  Thirteen sub-acute patients (<3 months from stroke onset) participated in the study. All patients completed 6 weeks of gait training (3 weeks of robotic gait training and 3 weeks of physiotherapy). The gait patterns were analyzed using 3D motion analysis before and after training. The assessed variables were; gait speed and the net peak joint power of the ankle plantar flexors, hip extensors, hip flexors, hip abductors, and knee extensors.
  
  
  RESULTS
  Ankle plantar flexor power in the impaired limb and hip extensor power in the unimpaired limb increased significantly following training (133% and 77%, respectively; P<0.002). Improvements (from 20% to 133%) in net joint power of the ankle plantar flexors, hip extensors, hip flexors, and hip abductors of the impaired limb and ankle plantar flexors and hip abductors of the unimpaired limb significantly correlated with the recovery of walking speed following training (0.24 m/s to 0.51 m/s) (r=0.71-0.86).
  
  
  CONCLUSIONS
  The findings suggested investigations for strengthening the plantar flexors, hip flexors, hip extensors, and hip abductors concentrically, and knee extensors eccentrically in the impaired limb to determine the effectiveness in improving gait performance.
authors: Hammel Neurorehabilitation and Research Centre, Voldbyvej 15, 8450 Hammel, Denmark. jobr@viauc.dk
authors: John
authors: J
authors: Brincks
authors: Jørgen Feldbæk
authors: JF
authors: Nielsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004735:Energy Transfer; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D005082:Physical Exertion; D020127:Recovery of Function; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D016138:Walking