Rate of torque development of paretic lower limb is an excellent predictor of walking speed in chronic stroke individuals

Raiff Simplicio da Silva; Mikhail Santos Cerqueira; Daniel Germano Maciel; Stephano Tomaz da Silva; Marianna Celeste Cordeiro de Figueiredo; Daiane Carla Rodrigues Cardoso; Sinval Bezerra Nóbrega Neto; Clarissa Fernandes Bezerra; Rafael Pereira; Wouber Hérickson de Brito Vieira; Tatiana Souza Ribeiro

doi:10.1016/j.clinbiomech.2021.105527

Rate of torque development of paretic lower limb is an excellent predictor of walking speed in chronic stroke individuals

Clin Biomech (Bristol, Avon). 2022 Jan:91:105527. doi: 10.1016/j.clinbiomech.2021.105527. Epub 2021 Nov 13.

Affiliations

¹ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: raiffsimplicio@gmail.com.
² Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: mikalsantosc@hotmail.com.
³ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: danielgmaciel@gmail.com.
⁴ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: stephanotz@gmail.com.
⁵ Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN, Zip Code: 59072-970, Brazil. Electronic address: marianna_celeste@hotmail.com.
⁶ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: dadacrc@gmail.com.
⁷ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: sinvalneto97@outlook.com.
⁸ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: clarissafernandesbezerra@gmail.com.
⁹ Biomedical Engineering from the Brazil University, Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, s/n, Rua José Moreira Sobrinho, 45210506, Brazil. Electronic address: rafaelpereira@uesb.edu.br.
¹⁰ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: hericksonfisio@yahoo.com.br.
¹¹ Physical Therapy from the Federal University of Rio Grande do Norte, Department of Physical Therapy, Federal University of Rio Grande do Norte, 3000, Av. Senador Salgado Filho, Post office box: 1524, Natal, RN 59072-970, Brazil. Electronic address: ribeirotatiana.ufrn@gmail.com.

PMID: 34915434
DOI: 10.1016/j.clinbiomech.2021.105527

Abstract

Background: Walking speed discriminates levels of functionality in stroke survivors, but its relationship with neuromuscular parameters remains unclear. We aimed to (1) verify relationships between walking speed, peak torque, and rate of torque development in individuals with chronic stroke and (2) investigate whether adjusting the predictive model for assistive device use and lower limb motor function improves its accuracy.

Methods: Twenty-nine stroke survivors (time post-stroke ≥6 months) were assessed for walking speed, motor function, torque of knee extensors, and rate of torque development. Hierarchical multiple regression was conducted to infer the contribution of assistive device use and lower limb motor function in the proportion of variance in walking speed explained by neuromuscular parameters. Adequacy of regression models was verified using Shapiro-Wilk test and visual inspection of histograms.

Findings: Rate of torque development measures presented higher coefficients of determination (R² = 0.399-0.457) than peak torque (R² = 0.333). However, no differences were observed between correlation coefficients (P > 0.05). When adjusted for assistive device use and lower limb motor function, coefficients of determination of all neuromuscular parameters were improved (P < 0.05). Regression models showed good adequacy.

Interpretation: Peak torque and rate of torque development from knee extensors are adequate predictors of walking speed in stroke survivors. Adjusting predictive models for assistive device use and lower limb motor function increases predictive capacity. These findings may have repercussions for assessing chronic stroke individuals and developing treatment strategies.

Keywords: Cerebrovascular accident; Gait disorders; Motor function; Muscle strength; Neurological rehabilitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Lower Extremity
Muscle Strength
Stroke Rehabilitation*
Torque
Walking
Walking Speed*