Hip flexor and ankle dorsiflexor strength associated with gait speed in post-stroke hemiparesis: Cross-sectional...

Lower-limb flexor muscle strength, including hip flexor (HF) and ankle dorsiflexor (AD) strength, is important for limb advancement and walking after stroke. However, their individual and combined associations with gait speed (GS) in adults with post-stroke hemiparesis are not well understood, especially in KSA. Thus, the present study examined the individual and combined associations of HF and AD strength with GS in this population.

This cross-sectional study included 60 ambulatory adults with post-stroke hemiparesis who were recruited from a tertiary rehabilitation hospital in Riyadh. Isometric HF and AD strength (N·m/kg) were measured using standardized handheld dynamometry. GS (m/s) was assessed using an electronic walkway. Associations were analyzed based on Pearson's correlation coefficients (r) and linear regression, both unadjusted and adjusted for age, sex, stroke type, stroke chronicity, hemiparesis side, and body mass index.

HF strength was more strongly correlated with GS (r = 0.45; 95% confidence interval [CI], 0.22-0.63; P < 0.001) than AD strength (r = 0.27; 95% CI, 0.01-0.49; P = 0.041). In the adjusted regression models, HF strength remained significantly associated with GS (β = 0.74; P = 0.001), explaining 41% of the variance. AD was not significantly associated with GS when both variables were included. These coefficients were partially adjusted because the models excluded relevant muscle groups, such as knee extensors and ankle plantar flexors.

HF strength was associated with GS in post-stroke hemiparesis, whereas AD strength did not provide additional explanatory value. These findings may support prioritizing proximal lower-limb strengthening during stroke rehabilitation.