Gait Performance and Lower-Limb Muscle Strength Improved in Both Upper-Limb and Lower-Limb Isokinetic Training Programs in Individuals with Chronic Stroke

Abstract

Background. Limited improvement in gait performance has been noted after training despite a significant increase in strength of the affected lower-limb muscles after stroke. A mismatch between the training program and the requirements of gait could explain this finding. Objective. To compare the impact of a training program, matching the requirements of the muscle groups involved in the energy generation of gait, to a control intervention, on gait performance and strength. Methods. 30 individuals with chronic stroke were randomly assigned into two groups (n = 15), each training three times/week for six weeks. The experimental group trained the affected plantarflexors, hip flexors, and extensors, while the control group trained the upper-limb muscles. Baseline and posttraining values of gait speed, positive power (muscles’ concentric action during gait), and strength were retained and compared between groups. Results. After training, both groups showed a similar and significant increase in gait speed, positive power of the hip muscles, and plantarflexors strength. Conclusion. A training program targeting the lower-limb muscles involved in the energy generation of gait did not lead to a greater improvement in gait performance and strength than a training program of the upper-limb muscles. Attending the training sessions might have been a sufficient stimulus to generate gains in the control group.