title: The relationship between bilateral knee muscle strength and gait performance after stroke: the predictive value for gait performance.
abstract: [Purpose] The purpose of this study was to assess the relationships between bilateral knee extension strengths and gait performance in subjects with poststroke hemiparesis and to predict gait performance by the paretic and nonparetic knee extension strength. [Subjects and Methods] This was a correlational study in which 238 consecutive inpatients with poststroke hemiparesis were enrolled. Knee extensor muscle strengths in paretic and nonparetic lower limbs were measured with a handheld dynamometer, and the presence or absence of impaired gait was also determined. [Results] The mean strength in the paretic lower limb was 0.90 Nm/kg, and that in the nonparetic lower limb was 1.24 Nm/kg. Discriminant analysis classified the difference between the possibility and impossibility of gait by knee extensor muscle strength (standardized discriminant coefficient: paretic, 1.32; nonparetic, 0.55). Thus, paretic and nonparetic knee extension strengths were integrated in the strength index. A threshold level of 2.0 provided the best balance between positive and negative predictive values for the strength index. [Conclusion] The results indicated that both paretic and nonparetic knee extension strengths were related to gait performance. The strength index deduced from bilateral knee extension strengths may serve as a clinically meaningful index for rehabilitation assessment and training.
authors.affiliation: School of Allied Health Sciences, Kitasato University, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: School of Allied Health Sciences, Kitasato University, Japan ; Graduate School of Medical Sciences, Kitasato University, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Rehabilitation Medicine, Kawasaki Municipal Tama Hospital, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sugimura
authors.affiliation: School of Allied Health Sciences, Kitasato University, Japan ; Graduate School of Medical Sciences, Kitasato University, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: School of Allied Health Sciences, Kitasato University, Japan ; Graduate School of Medical Sciences, Kitasato University, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Graduate School of Medical Sciences, Kitasato University, Japan ; Department of Rehabilitation Medicine, Sagamihara Chuo Hospital, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shibata
authors.affiliation: School of Allied Health Sciences, Kitasato University, Japan ; Graduate School of Medical Sciences, Kitasato University, Japan.
authors.forename: Michinari
authors.initials: M
authors.lastname: Fukuda
keywords: Gait; Handheld dynamometer; Stroke