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Stroke-related effects on maximal dynamic hip flexor fatigability and functional implications.

Henry R Kuhnen1, Megan M Rybar, Tanya Onushko

  • 1Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA.

Muscle & Nerve
|November 18, 2014
PubMed
Summary

Maximal dynamic hip flexor fatigability in stroke survivors is more functionally relevant than isometric measures. Dynamic torque reduction in the paretic leg predicts walking speed better.

Keywords:
dynamic contractionship flexorsneuromuscular fatiguestrokewalking

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Area of Science:

  • Neurology
  • Rehabilitation Science
  • Movement Science

Background:

  • Stroke frequently impairs motor function, particularly in the lower extremities.
  • Hip flexor muscle fatigability is a key factor affecting gait and mobility post-stroke.

Purpose of the Study:

  • To compare the functional relevance of dynamic versus isometric hip flexor muscle fatigability in chronic stroke survivors.
  • To determine if hip flexor fatigability predicts walking function after stroke.

Main Methods:

  • Ten chronic stroke survivors underwent 5 sets of 30 maximal dynamic voluntary contractions (MDVC) for hip flexion.
  • Maximal isometric voluntary contractions (MIVC) were measured pre- and post-dynamic testing for both paretic and nonparetic legs.
  • Electromyography (EMG) of the rectus femoris was recorded during dynamic contractions.

Main Results:

  • Greater reduction in hip flexion MDVC torque was observed in the paretic leg (44.7%) compared to the nonparetic leg (31.7%).
  • The paretic leg showed a significantly larger decrease in rectus femoris EMG during dynamic contractions than the nonparetic leg.
  • Reduced paretic leg MDVC torque correlated with self-selected walking speed (r²=0.43), unlike MIVC torque reduction (r²=0.11).

Conclusions:

  • Maximal dynamic hip flexor fatigability, especially in the paretic limb, is a more sensitive indicator of functional impairment post-stroke.
  • Dynamic hip flexor torque reduction appears to be a better predictor of walking function than isometric measures in stroke survivors.