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The purpose of this study was to identify 3D kinematic and kinetic gait profiles in individuals with chronic stroke and to determine whether the magnitude or pattern (shape and direction of curve) of these profiles relate to gait performance (as measured by self-selected gait speed). More than one type of kinematic and kinetic pattern was identified in all three planes in 20 individuals with stroke (age = 61.2 ± 8.4 years). Persons in the "fast" speed group did not necessarily exhibit the gait patterns closest to the ones reported for healthy adults. For example, in the frontal plane, a variation from the typical pattern (i.e., a hip abductor pattern in swing) was more common among the "fast" group. Correlations revealed that in addition to the sagittal profiles, the magnitudes of the frontal and transverse profiles are also related to speed, particularly the frontal hip powers. The results support the importance of hip abductors, in addition to the sagittal plane muscle groups, for both the paretic and non-paretic limbs. Furthermore, profiles which resemble gait patterns of neurologically healthy adults do not necessarily result in the faster gait speeds for individuals with chronic stroke.

Objectives-The goal most often stated by persons with stroke is improved walking function. The purpose of this study was to determine the effects of isokinetic strength training on walking performance, muscle strength, and health-related quality of life in survivors of chronic stroke.Methods-Twenty participants (age, 61.2 ± 8.4 years) with chronic stroke were randomized into 2 groups. The experimental group undertook maximal concentric isokinetic strength training, whereas the control group received passive range of motion of the paretic lower extremity 3 times a week for 6 weeks. The Kin-Com Isokinetic Dynamometer (Chattanooga Group Inc., TN) was used for both the strengthening and passive range of motion exercises. The Mann-Whitney U test was used to compare the changes in scores (postintervention minus baseline) between the control and experimental groups for a composite lower extremity strength score, walking speed (levelwalking and stair-walking) and health-related quality of life measure (36-Item Short Form Health Survey ).Results-Both the experimental and control groups increased their strength and walking speed postintervention; however, there were no differences in the changes in walking speed between the groups. There was a trend (P = .06) toward greater strength improvement in the experimental group compared with the control group. No changes in SF-36 scores were found in either group.Conclusions-Intervention aimed at increasing strength did not result in improvements in walking. The results of this study stress the importance of controlled clinical trials in determining the effect of specific treatment approaches. Strength training in conjunction with other task-related training may be indicated.

Objective-To determine the reliability of isokinetic concentric strength measures of both the hemiparetic and non-involved limbs for flexion and extension motions of the hip, knee, and ankle joints in individuals who have had a stroke.Design-Test-retest, repeated-measures intraobserver reliability design. Setting-Tertiary rehabilitation center.Participants-20 community-dwelling individuals who have had a stroke, with motor deficits ranging from 3 to 6 on the Chedoke-McMaster Stroke Assessment; volunteer sample. Interventions-Not applicable.Main Outcome Measures-Peak torque and average torque (ie, mean over the range of motion tested) from an ensemble-averaged (three trials) torque-angle curve during isokinetic concentric extension and flexion movements of the ankle, knee, and hip.Results-Although peak and average torque were significantly less for the hemiparetic limb compared with the non-involved limb, the intraclass correlation coefficients (ICCs) between the two test sessions were high (0.95-0.99 for peak torque, 0.88-0.98 for average torque) for both limbs for all 3 joints. However, there was a learning effect, as observed by the slightly greater values attained from the second test session.Conclusions-Peak and average isokinetic torque can be used to assess reliably lower extremity strength in persons with chronic stroke. Practice sessions may be required before the actual test to reduce the effect of learning.