Association of Activity Limitations and Lower-Limb Explosive Extensor Power in Ambulatory People With Stroke

Abstract 

Saunders DH, Greig CA, Young A, Mead GE. Association of activity limitations and lower-limb explosive extensor power in ambulatory people with stroke.

Objective

To determine whether the explosive lower-limb extensor power of the affected and unaffected sides, and any asymmetry, are associated with activity limitations after stroke.

Design

Cross-sectional observational study of baseline data from a randomized controlled trial.

Setting

Measurements made in a hospital clinical research facility.

Participants

Community-dwelling (N=66) subjects with stroke who were independently ambulatory. Subjects’ mean age was 72±10 years.

Interventions

Not applicable.

Main Outcome Measures

The lower-limb extensor power of each lower limb (in W/kg), performance of specific functional activities (comfortable walking velocity, Functional Reach Test, chair-rise time, Timed Up & Go test), and global indices of activity limitation (FIM instrument, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living).

Results

Low lower-limb extensor power in either lower limb was the principal factor from among the confounders we recorded that significantly (R² range, .21–.46) predicted the limitation of specific functional activities, and low lower-limb extensor power in either lower limb was the principal predictive factor for global indices of activity limitation (R² range, .13–.38). The degree of asymmetry of lower-limb extensor power between legs was low and had little or no predictive value.

Conclusions

In ambulatory persons with stroke, activity limitations are associated with deficits in lower-limb extensor power of both lower limbs, and not the severity of any residual asymmetry. These findings suggest that interventions to increase lower-limb extensor power in both lower limbs might reduce activity limitations after stroke.

Key Words: Activities of daily living, Cerebrovascular accident, Physical fitness, Rehabilitation