title: The strength of the ankle dorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke: an observational study.
abstract: OBJECTIVE
  To investigate the relationship between the strength of muscles of the affected lower limb and walking speed after stroke.
  
  
  METHODS
  A cross-sectional observational study.
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  Stroke survivors (N=60; mean age ± SD, 69±11y) 1 to 6 years poststroke, able to walk 10m independently without aids.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Maximum isometric strength of 12 muscle groups (hip flexors/extensors, adductors/abductors, internal/external rotators, knee flexors/extensors, ankle dorsiflexors/plantarflexors, invertors/evertors) of the affected lower limb was measured using hand-held dynamometry. Comfortable walking speed was measured using the ten-meter walk test.
  
  
  RESULTS
  Univariate analysis revealed that strength of the hip flexors (r=.35, P=.01), hip extensors (r=.29, P=.03), hip internal rotators (r=.30, P=.02), hip adductors (r=.29, P=.03), knee extensors (r=.27, P=.03), knee flexors (r=.30, P=.02), ankle dorsiflexors (r=.50, P=.00), ankle plantarflexors (r=.29, P=.03), and ankle evertors (r=.33, P=.01) were all positively associated with walking speed. Multivariate analysis (n=58) revealed that the combined strength of the ankle dorsiflexors and the hip flexors accounted for 34% of the variance in walking speed (P<.001). The ankle dorsiflexors accounted for 31% of the variance (P<.001).
  
  
  CONCLUSIONS
  The strength of muscle groups other than the lower limb extensors, particularly the ankle dorsiflexors, has an important role in determining walking speed after stroke.
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
authors.forename: Simone
authors.initials: S
authors.lastname: Dorsch
authors.forename: Louise
authors.initials: L
authors.lastname: Ada
authors.forename: Colleen G
authors.initials: CG
authors.lastname: Canning
authors.forename: Matar
authors.initials: M
authors.lastname: Al-Zharani
authors.forename: Catherine
authors.initials: C
authors.lastname: Dean
mesh_terms: D000054:Acceleration; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000843:Ankle Joint / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000502:physiology*; D009517:New South Wales; D016059:Range of Motion, Articular / Q000502:physiology*; D012044:Regression Analysis; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D017741:Survivors; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*