Effects of individualized lower limb isokinetic strengthening in clinical rehabilitation of older post-stroke patients: A retrospective study

Abstract

Objective: Muscle weakness in the lower limbs is a motor consequence of stroke that causes functional impairment. The aim of this study was to assess the effectiveness of an individualized isokinetic strengthening programme, using the moment-velocity profile, on functional recovery during post-stroke rehabilitation of older patients. A further objective was to describe the effects of the individualized isokinetic strengthening on muscular parameters.Design: Retrospective study.Patients: Older post-stroke patients.Methods: Using the Barthel Index, functional abilities in basic daily tasks were assessed and retrospectively analysed for 88 patients in a post-stroke rehabilitation unit. Of these, 44 patients received conventional rehabilitation (conventional group) and 44 received individualized isokinetic strengthening in addition to conventional rehabilitation (isokinetic group). A 2-Group (isokinetic, conventional) × 2-Time (before, after intervention) repeated measures analysis of variance (ANOVA) was conducted. For muscular parameters, Student t-tests and Wilcoxon tests were performed.Results: The Barthel Index score increased more in the isokinetic group (61.59 ± 26.34 to 88.18 ± 12.16) than in the conventional group (61.70 ± 26.5 to 76.93 ± 18.12). A significant Time × Group interaction was found (F(1,86) = 5.95, p = 0.02). In the isokinetic group all muscular parameters improved.Conclusion: This retrospective clinical study suggests that lower limb isokinetic strengthening, individualized using the moment-velocity profile, is clinically efficient for functional recovery during post-stroke rehabilitation of older patients. Intragroup effects of isokinetic strengthening also suggest benefits for muscular parameters. LAY ABSTRACTMuscle weakness in the lower limbs is a motor consequence of stroke that limits abilities to accomplish activities of daily life, such as walking. Individualized isokinetic exercises, based on patient’s force deficit and using a specialized equipment that adapts resistance according to the amount of force applied in order to maintain a constant speed throughout the movement, were performed in a post-stroke rehabilitation unit for older adults with sub-acute stroke. Retrospective analysis showed that functional recovery, as assessed by the clinical Barthel Index, was better in the patient who received individualized isokinetic strengthening in addition to conventional rehabilitation, compared with those who received only conventional rehabilitation. In addition, the results suggest beneficial effects on muscular parameters, such as force.