The purpose of this study is to assess the impact of an isokinetic strength training of knee flexor and extensor muscles on walking performance in hemiparetic patients with knee extension thrust.
The study will be interventional single case experimental design (SCED) with multiple baseline design. SCED are experimental designs aiming at testing the effect of an intervention using a small number of patients using repeated measurements, sequential and randomized introduction of an intervention and method-specific data analysis, including visual analysis and specific statistics. During baseline, patients will have a rehabilitation program in day hospital (4 days per week) with physiotherapy and physical activity and if necessary occupational and speech therapy. Isokinetic strength training will be added to this conventionnal rehabilitation program and will begin after 3, 4 or 5 weeks of baseline according to randomization 12 patients will be included in this study (6 patients in subacute stage and 6 in chronic stage ).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
12
Patients underwent an isokinetic strength training program with 3 sessions per week during five weeks. Program consists of excentric contraction of knee flexor and extensor muscles (4 x 7 Contractions at 30°/s) and concentric contractions at maximal speed where patients can perform 40% of his maximal isometric torque for knee flexor and extensor muscles (2x10 for knee flexors and 2x10 for knee extensors)
CHU de Rennes
Rennes, France
RECRUITINGspontaneous walking speed
Spontaneous walking speed of hemiparetic patients recorded with 3D gait analysis
Time frame: 25 weeks
Extensor thrust analysis
Extensor thrust at spontaneous and maximal walking speed and during dual task recorded with 3D gait analysis
Time frame: 25 weeks
Walking speed
assessment of walking speed in two conditions (maximal speed and dual task)
Time frame: 25 weeks
Stairs test
time to ascend and descend stairs (maximal speed)
Time frame: 25 weeks
Inclined plan
time to walk in an inclined plan (maximal speed)
Time frame: 25 weeks
6-minute walk test
Assessment of maximum gait perimeter during a 6MWT (6-minute walk test :6MWT)
Time frame: 25 weeks
Sit to stand test
1 minute sit to stand test (number of repetitions)
Time frame: 25 weeks
Extensor thrust during locomotor tasks
Extensor thrust analysis with inertial measurement unit (stairs, inclined walk, 6MWT and sit to stand )
Time frame: 25 weeks
Fatigue
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Fatigue severity scale : FSS (minimum 9 -maximum 63 ; a higher score means higher level of fatigue)
Time frame: 25 weeks
Likert Scale
self perception of walking stability, fear of fall, trouble with extensor thrust with a likert scale
Time frame: 25 weeks
Strength
strength of knee flexor and extensor muscles assessed with isokinetic dynamometer
Time frame: 25 weeks