Effect of power training on rate of torque development and spatiotemporal gait parameters post stroke

• Published in: Clinical biomechanics (Bristol) Vol. 105; p. 105953
• Main Authors: Williams, Ewan R., VanDerwerker, Catherine J., Ross, Ryan E., Evans, Ellen M., Gregory, Chris M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2023
• Subjects: Chronic stroke; Female; Gait; Gait - physiology; Humans; Intervention; Power training; Stroke - complications; Stroke Rehabilitation; Torque; Torque development; Walking - physiology; Intervention; Power training; Gait; Torque development; Chronic stroke
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2023.105953

Maximizing independence and function post-stroke are two common therapy goals. Rate of torque development in lower-extremity muscles was recently reported to be associated with walking speed; however, trainability and subsequent effect on gait is unknown. This study aimed to determine effect of power training on paretic and non-paretic limb torque parameters, spatiotemporal gait parameters, and walking speed in chronic stroke survivors. Individuals with chronic stroke (n = 22; 7 females; 62.7 ± 8.8 yrs) completed 24 progressive power-training sessions over 8 weeks with pre and post assessments. Knee extensor strength was assessed via dynamometry with torque parameters measured from maximal voluntary isometric contractions. Gait speed and spatiotemporal gait parameters were assessed via an instrumented gait mat, and a 6-min walk test was performed. Rate of torque development at 200 ms and peak torque improved 58.6% and 14.1%, respectively, in the quadricep of the paretic limb (p < 0.05); conversely the non-paretic limb was unchanged. On average, self-selected walking speed, fastest-comfortable walking speed, and 6-min walk test improved 21.7%, 21.1%, and 19.5%, respectively (all p < 0.05). Change in torque development at 100 ms in the quadricep of the non-paretic limb was positively associated with improvements in self-selected and fastest-comfortable walking speeds (both r = 0.70, p < 0.05) and 6-min walk (r = 0.78, p < 0.001). These findings suggest power training may be an effective intervention for improving torque development in the quadricep of the paretic limb in individuals with chronic stroke. Further research to explore utility and mechanistic aspects of force development for gait function in chronic stroke survivors is warranted. •Power training may improve quadricep rate of torque development in stroke survivor paretic limbs.•Power training may improve self-selected and fastest walking speed of chronic stroke survivors.•Improvement in non-paretic limb rate of torque development may improve walking speed after stroke.