Section of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Arch Phys Med Rehabil. 2013 May;94(5):845-50. doi: 10.1016/j.apmr.2012.11.034. Epub 2012 Dec 3.
To evaluate the relation between muscle strength in the lower extremities and walking performance (speed and distance) in subjects in the later stage poststroke and to compare this with normative data.
A cross-sectional observational study.
University hospital department.
Subjects poststroke (n=41; 31 men, 10 women) with a mean age of 59±5.8 years and a time from stroke onset of 52±36 months were evaluated. An urban sample (n=144) of 40- to 79-year-olds (69 men, 75 women) formed the healthy reference group.
Not applicable.
Muscle strength in the lower extremities was measured with an isokinetic dynamometer and combined into a strength index. Values for the 30-meter walk test for self-selected and maximum speed and the 6-minute walk test were measured. A nonlinear regression model was used.
The average strength index was 730±309 in the subjects after stroke compared with 1112±362 in the healthy group. A nonlinear relation between walking performance and muscle strength was evident. The model explained 37% of the variance in self-selected speed in the stroke group and 20% in the healthy group, and 63% and 38%, respectively, in the maximum walking speed. For the 6-minute walk test, the model explained 44% of the variance in the stroke group.
Subjects in the later stage poststroke were weaker than the healthy reference group, and their weakness was associated with walking performance. At the same strength index, subjects walked at lower speeds and shorter distances after stroke, indicating that there are multiple impairments that affect walking ability. Treatments focused on increasing muscle strength thus continue to hold promise.
评估下肢肌肉力量与脑卒中后晚期患者行走速度和距离（速度和距离）之间的关系，并与参考数据进行比较。
横断面观察性研究。
大学医院。
评估了 41 名脑卒中后患者（31 名男性，10 名女性），平均年龄为 59±5.8 岁，脑卒中发病时间为 52±36 个月。一个由 40 至 79 岁的城市样本（n=144；69 名男性，75 名女性）组成了健康对照组。
不适用。
使用等速测力仪测量下肢肌肉力量，并将其组合成一个力量指数。测量 30 米步行试验的自我选择速度和最大速度，以及 6 分钟步行试验的速度。使用非线性回归模型。
与健康对照组的 1112±362 相比，脑卒中后患者的平均力量指数为 730±309。行走性能与肌肉力量之间存在非线性关系。该模型解释了脑卒中组自我选择速度变化的 37%，健康组的 20%，最大行走速度的 63%和 38%。对于 6 分钟步行试验，该模型解释了脑卒中组 44%的方差。
脑卒中后晚期患者的肌肉力量比健康对照组弱，其虚弱与行走能力有关。在相同的力量指数下，脑卒中患者的行走速度和距离都较低，这表明存在多种影响行走能力的损伤。因此，以增强肌肉力量为重点的治疗方法仍然具有很大的希望。
