Article

OBJECTIVES: (1) To determine the relationships of ankle dorsiflexor strength,
ankle plantarflexor strength, and spasticity of the ankle plantarflexors with
walking endurance; (2) to determine whether affected ankle dorsiflexor strength
makes an independent contribution to walking endurance; and (3) to quantify its
relative contribution to the walking endurance of people with spastic hemiplegia
after stroke. DESIGN:
A cross-sectional study. SETTING: University-based
rehabilitation center. PARTICIPANTS: Subjects (N=62) with spastic hemiplegia.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Walking endurance was
measured by the distance covered in the six-minute walk test (6MWT). Ankle
dorsiflexor and plantarflexor strength were measured using a load-cell mounted on
a custom-built foot support. Plantarflexor spasticity was measured using the
Composite Spasticity Scale. RESULTS: The six-minute walk distances showed
stronger positive correlation with affected dorsiflexor strength (r=.793,
P</=.000) when compared with affected plantarflexor strength (r=.349, P=.005).
Results of the regression model showed that after adjusting for basic demographic
and stroke-related impairments, affected ankle dorsiflexor strength remained
independently associated with six-minute walk distance, accounting for 48.8% of
the variance. CONCLUSIONS: This is the first study, to our knowledge, to document
the importance of ankle dorsiflexor strength as an independent determinant of
walking endurance in stroke survivors with spastic plantarflexors. Our findings
suggest that stroke rehabilitation programs aiming to improve walking endurance
should include strengthening exercises for the ankle dorsiflexors.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS