Cukurova University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana-Turkey.
Cukurova University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana-Turkey.
J Stroke Cerebrovasc Dis. 2020 Apr;29(4):104658. doi: 10.1016/j.jstrokecerebrovasdis.2020.104658. Epub 2020 Feb 7.
The aim of the study was to investigate the relation of lower limb muscle strength with normalized walking value, gait speed, and balance in patients with poststroke hemiplegia.
Functional ambulatory unilateral hemiplegic patients were included in the study. Functionality of the lower limb was tested by Fugl-Meyer lower extremity motor subscale. Six-minute walk test (6MWT), 10-meter walk test, and Berg Balance Scale were performed to evaluate functional walking capacity, gait speed, and balance, respectively. Normalized 6MWT value was calculated by using a formula. Maximum isometric strengths of 8 muscle groups of both limbs were measured using a handheld dynamometry and residual deficits of the paretic side muscles were calculated.
The study population was comprised of 61 hemiplegic patients (mean age: 54.6 ± 11.7 years and mean duration after stroke: 23.4 ± 18.1 months). Mean normalized walking distance on 6MWT was 44.4% of expected. The residual deficits of the affected lower extremity muscles were negatively correlated with normalized 6MWT: hip flexors (r = -.651), hip extensors (r = -.621), hip abductors (r = -.657), hip adductors (r = -.630), knee flexors (r = -.738), knee extensors (r = -.659), ankle dorsiflexors (r = -.776), and ankle plantar flexors (r = -.773). Lower extremity residual deficits also showed moderate-strong negative correlations with Berg Balance Scores and gait speed. Multiple linear regression analyses showed that the residual deficits of the ankle plantar flexors and knee flexors are the major independent determinants of normalized 6MWT results (R: .791 R: 625).
Residual deficits of lower extremity muscles-particularly of ankle dorsiflexors, plantar flexors, and knee flexors-are related to walking performance, gait speed and balance. Besides, knee flexors and plantar flexors are predictors of normalized 6MWT.
本研究旨在探讨下肢肌肉力量与脑卒中偏瘫患者正常化步行值、步行速度和平衡之间的关系。
本研究纳入了功能性单肢偏瘫患者。下肢功能通过 Fugl-Meyer 下肢运动子量表进行测试。6 分钟步行试验（6MWT）、10 米步行试验和 Berg 平衡量表分别用于评估功能性步行能力、步行速度和平衡。通过公式计算正常化 6MWT 值。使用手持测力计测量双侧 8 个肌肉群的最大等长力量，并计算患侧肌肉的残余缺陷。
研究人群由 61 名偏瘫患者组成（平均年龄：54.6±11.7 岁，卒中后平均时间：23.4±18.1 个月）。6MWT 上的平均正常化步行距离为预期的 44.4%。患侧下肢肌肉的残余缺陷与正常化 6MWT 呈负相关：髋关节屈肌（r=-0.651）、髋关节伸肌（r=-0.621）、髋关节外展肌（r=-0.657）、髋关节内收肌（r=-0.630）、膝关节屈肌（r=-0.738）、膝关节伸肌（r=-0.659）、踝关节背屈肌（r=-0.776）和踝关节跖屈肌（r=-0.773）。下肢残余缺陷与 Berg 平衡评分和步行速度也呈中度到强的负相关。多元线性回归分析显示，踝关节跖屈肌和膝关节屈肌的残余缺陷是正常化 6MWT 结果的主要独立决定因素（R²：0.791，R²：0.625）。
下肢肌肉的残余缺陷——特别是踝关节背屈肌、跖屈肌和膝关节屈肌——与步行能力、步行速度和平衡有关。此外，膝关节屈肌和跖屈肌是正常化 6MWT 的预测因子。
