Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May 14;18(1):57.
doi: 10.1186/s12938-019-0678-6.

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

Ewa Chlebuś  1 , Agnieszka Wareńczak  2 , Margaret Miedzyblocki  2 , Przemysław Lisiński  2
Affiliations

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

Ewa Chlebuś et al. Biomed Eng Online. .

Abstract

Background: Ankle joint function in a paretic limb has a fundamental impact on mobility. Return of joint function is a measure of early poststroke physical rehabilitation. This study aims to assess the suitability of using the isometric protocol for objective evaluation of flexor and extensor muscle strength in the paretic limb of poststroke patients.

Methods: 34 patients (F: 9, M: 25) aged 51-79 years with hemiparesis following an acute ischemic stroke and 34 healthy controls were examined using the isometric protocol measured on the Biodex System®. The following parameters were analyzed: peak torque [PT], average torque [AVGT], average torque/body weight [AVGT/BW] for flexors and extensors, and AVGT flexor/AVGT extensor [agonist/antagonist ratio] of the paretic foot, the nonparetic foot and foot of healthy controls using three foot-shank positions (15°, 0°, and - 15°) prior to rehabilitation commencement and at its completion 16 weeks later.

Results: Prior to rehabilitation commencement, nonparetic foot differed significantly (p < 0.05) from healthy foot controls in all parameters and all positions for flexors and in all positions for foot-shank positions of 0° and - 15° for extensors. At rehabilitation program completion the following parameters increased significantly for the paretic foot: PT, AVGT, and AVGT/BW for foot extensors in all tested positions, and PT for foot flexors in foot-shank position of - 15°. The nonparetic foot however, showed no significant difference following rehabilitation regardless parameter or foot position tested for flexors and extensors alike. Prior to rehabilitation agonist/antagonist ratio in the paretic foot differed significantly from corresponding parameter in the control group for the foot-shank positions of 15° and 0°, whereas at rehabilitation completion, the two groups showed significant difference only in foot-shank position of 0°.

Conclusions: In the early period following stroke, there is a significant strengthening of the paretic limb, but no improvement in the strength of nonparetic limb.

Keywords: Isometric protocol; Paretic foot; Rehabilitation; Stroke.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Bioethical Commission of the Medical University of Poznań (Approval No. 539/18).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Similar articles

See all similar articles

Cited by

References

    1. Palmer JA, Hsiao H, Awad LN, et al. Symmetry of corticomotor input to plantarflexors influences the propulsive strategy used to increase walking speed post-stroke. Clin Neurophysiol. 2016;127:1837–1844. doi: 10.1016/j.clinph.2015.12.003. - DOI - PMC - PubMed
    1. Sekiguchi Y, Muraki T, Tanaka N, et al. Relationship between activation of ankle muscles and quasi-joint stiffness in early and middle stances during gait in patients with hemiparesis. Gait Posture. 2015;42:348–353. doi: 10.1016/j.gaitpost.2015.04.020. - DOI - PubMed
    1. Thajchayapong M, Alibiglou L, Lilaonitkul T, Mirbagheri MM. Mechanical abnormalities of the spastic ankle in chronic stroke subjects. Conf Proc IEEE Eng Med Biol Soc. 2006;1:3688–3691. doi: 10.1109/IEMBS.2006.260535. - DOI - PubMed
    1. Abe H, Michimata A, Sugawara K, Sugaya N, Izumi S. Improving gait stability in stroke hemiplegic patients with a plastic ankle–foot orthosis. Tohoku J Exp Med. 2009;218:193–199. doi: 10.1620/tjem.218.193. - DOI - PubMed
    1. Kemertzis MA, Lythgo ND, Morgan DL, et al. Ankle flexors produce peak torque at longer muscle lengths after whole-body vibration. Med Sci Sports Exerc. 2018;40:1977–1983. doi: 10.1249/MSS.0b013e31817eeeb8. - DOI - PubMed