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(Stroke. 2006;37:2070.)
© 2006 American Heart Association, Inc.

Original Contributions

Bilateral Level of Effort of the Plantar Flexors, Hip Flexors, and Extensors During Gait in Hemiparetic and Healthy Individuals

From the École de réadaptation (M-H.M., S.N., D.G., L.F.R.), Université de Montréal and Centre de recherche interdisciplinaire en réadaptation, Institut de réadaptation de Montréal, Canada, and the Universidade Tuiuti do Paraná (L.F.R.), Faculdade de Fisioterapia, Curitiba, Brazil.

Correspondence to Dr Sylvie Nadeau, Université de Montréal, Faculté de Médecine, École de réadaptation, CP 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7. E-mail sylvie.nadeau{at}umontreal.ca

Background and Purpose— Muscle weakness is recognized as a key factor in gait performance of poststroke individuals, but its impact on lower-limb muscular effort has been scarcely studied. The aims of this study were to compare the level of effort of the lower limbs of hemiparetic and able-bodied individuals and to assess the effect of side, cadence, and muscle group.

Methods— Seventeen chronic hemiparetic participants (7 females and 10 males) with a mean age of 60.5±13.4 years were assessed when walking. They were compared with a group of 14 able-bodied individuals. The level of effort was estimated from the muscular utilization ratio (MUR), which relates the walking moment of a given muscle group to its maximal potential moment. Peak MUR and MUR_area were used as main outcome measures.

Results— Hemiparetic individuals showed greater peak MUR values (45% to 78%) than the able-bodied subjects matched for cadence (24% to 63%). For both groups, the peak MUR values were similar between sides and increased with cadence. At self-selected cadence, the plantar flexors showed greater peak MUR values, whereas at maximal cadence, levels of effort for all muscles were equivalent. The MUR_area values at the hip joint were greater for the hemiparetic group, and both groups had values that increased with cadence. Differences between sides and muscle groups were noted for the hemiparetic and healthy individuals, respectively. Large peak MUR values were associated with high MUR_area values.

Conclusions— For a similar cadence, the levels of effort of hemiparetic individuals were greater than those of the able-bodied. In the presence of muscle weakness, similar bilateral levels of effort could mean that hemiparetic individuals relied on their sense of effort while walking.

Key Words: gait • rehabilitation • stroke

This article has been cited by other articles:

				A. M. Simon, B. M. Kelly, and D. P. Ferris Sense of Effort Determines Lower Limb Force Production During Dynamic Movement in Individuals With Poststroke Hemiparesis Neurorehabil Neural Repair, October 1, 2009; 23(8): 811 - 818. [Abstract] [PDF]