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Determining the cut-off value for knee extensor strength for identifying independence in gait in chronic stroke
Naoki Akazawa1, Naomi Okawa, Kimiyuki Tamura
1Department of Physical Therapy, Faculty of Health and Welfare, , Tokushima Bunri University, 770-8514 Tokushima, Japan. akazawa@tks.bunri-u.ac.jp.
Objective:
To determine the cut-off values for knee extensor strength on the paretic and non-paretic sides and both sides combined for identifying independence in gait in chronic stroke survivors.
Design:
Cross-sectional study.
Patients:
Sixty chronic stroke survivors.
Methods:
Functional Independence Measure (FIM) gait scores were measured, and the participants were allocated to the independent group (FIM gait score 6 or 7) or the dependent group (FIM gait score 1-5). Knee extensor strength on the paretic and non-paretic sides was measured using a handheld dynamometer.
Results:
Eighteen stroke survivors were allocated to the independent group and 42 to the dependent group. The receiver operating characteristic curve analyses revealed that the cut-off values for knee extensor strength were 0.46 Nm/kg (sensitivity 83% and specificity 67%; area under the curve (AUC) 0.816) on the paretic side, 0.65 Nm/kg (sensitivity 89% and specificity 55%; AUC 0.738) on the non-paretic side and 1.31 Nm/kg (sensitivity 83% and specificity 74%; AUC 0.811) for both sides combined.
Conclusion:
These cut-off values could help to identify stroke survivors who are no longer independent in gait because of decreasing knee extensor strength on the paretic and non-paretic sides.
