Isokinetic Strength Training in Hemiparetic Patient With Knee Extension Thrust
- Conditions
- Gait DisorderHemiparesis/Hemiplegia (One Sided Weakness/Paralysis)
- Interventions
- Behavioral: isokinetic strength training of knee extensor and flexor muscles
- Registration Number
- NCT05887440
- Lead Sponsor
- Rennes University Hospital
- Brief Summary
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.
- Detailed Description
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 ).
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 12
- Hemiparetic patient (hemorragic or ischemic stroke)
- Subacute stage (< 6 Months) ou chronic stage of stroke (> 6 months) (6 patients in each group)
- Age between 18 and 75 years
- Able to walk 10 meters independently without any assistive devices
- Knee extension thrust during stance phase of gait cycle (rapid posterior movement of the knee toward extension)
- Scheduled rehabilitation program with isokinetic strength training
- affiliation to a social security
- Patients who received and signed informed consent
- Major comprehension deficit that not allow to give informed consent and participate to isokinetic strength training (assessed with comprehension subscore of Langague screening Test)
- non stable (unstable cardiovascular condition)
- musculoskeletal disorders with knee pain that not allowed isokinetic strength training
- Botulinum toxin injection less than 3 months or repeated injection in lower limb,
- Proprioception trouble assessed with proprioception section of the Fugl-Meyer Assessment [FMA-P] 0/2
- spasticity of triceps surae ≥2 (Modified Ashworth scale)
- ankle dorsiflexion angle less than 90°
- pregnant women or breastfeeding
- persons with safety measure
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description 5 assessments isokinetic strength training of knee extensor and flexor muscles The randomisation provides for 5 assessments of baseline 4 assessments isokinetic strength training of knee extensor and flexor muscles The randomisation provides for 4 assessments of baseline 3 assessments isokinetic strength training of knee extensor and flexor muscles The randomisation provides for 3 assessments of baseline
- Primary Outcome Measures
Name Time Method spontaneous walking speed 25 weeks Spontaneous walking speed of hemiparetic patients recorded with 3D gait analysis
- Secondary Outcome Measures
Name Time Method Sit to stand test 25 weeks 1 minute sit to stand test (number of repetitions)
Extensor thrust analysis 25 weeks Extensor thrust at spontaneous and maximal walking speed and during dual task recorded with 3D gait analysis
Walking speed 25 weeks assessment of walking speed in two conditions (maximal speed and dual task)
Stairs test 25 weeks time to ascend and descend stairs (maximal speed)
Inclined plan 25 weeks time to walk in an inclined plan (maximal speed)
6-minute walk test 25 weeks Assessment of maximum gait perimeter during a 6MWT (6-minute walk test :6MWT)
Extensor thrust during locomotor tasks 25 weeks Extensor thrust analysis with inertial measurement unit (stairs, inclined walk, 6MWT and sit to stand )
Fatigue 25 weeks Fatigue severity scale : FSS (minimum 9 -maximum 63 ; a higher score means higher level of fatigue)
Likert Scale 25 weeks self perception of walking stability, fear of fall, trouble with extensor thrust with a likert scale
Strength 25 weeks strength of knee flexor and extensor muscles assessed with isokinetic dynamometer
Trial Locations
- Locations (1)
CHU de Rennes
🇫🇷Rennes, France