Muscle Atrophy and Functional Deficits of Knee Extensors and Flexors in People With Chronic Stroke

Author:

Prado-Medeiros Christiane L.1,Silva Milla P.2,Lessi Giovanna C.3,Alves Marcela Z.4,Tannus Alberto5,Lindquist Ana R.6,Salvini Tania F.7

Affiliation:

1. C.L. Prado-Medeiros, PT, PhD, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.

2. M.P. Silva, PT, Department of Physical Therapy, Federal University of São Paulo, São Paulo, Brazil.

3. G.C. Lessi, PT, MS, Department of Physical Therapy, Federal University of São Carlos.

4. M.Z. Alves, PT, Itu, São Paulo, Brazil.

5. A. Tannus, PhD, Physics Institute of São Carlos, University of São Paulo.

6. A.R. Lindquist, PT, PhD, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

7. T.F. Salvini, PT, PhD, Department of Physical Therapy, Federal University of São Carlos, 13565-905, São Carlos, São Paulo, Brazil.

Abstract

BackgroundFurther clarification is needed with regard to the degree of atrophy in individual muscle groups and its possible relationship to joint torque deficit poststroke.ObjectiveThe purpose of this study was to investigate quadriceps and hamstring muscle volume and strength deficits of the knee extensors and flexors in people with chronic hemiparesis compared with a control group.DesignThis was a cross-sectional study.MethodsThirteen individuals with hemiparesis due to chronic stroke (hemiparetic group) and 13 individuals who were healthy (control group) participated in this study. Motor function, quadriceps and hamstring muscle volume, and maximal concentric and eccentric contractions of the knee extensors and flexors were assessed.ResultsOnly the quadriceps muscle of the paretic limb showed reduced muscle volume (24%) compared with the contralateral (nonparetic) limb. There were no differences in muscle volume between the hemiparetic and control groups. The peak torque of the paretic-limb knee extensors and flexors was reduced in both contraction modes and velocities compared with the nonparetic limb (36%–67%) and with the control group (49%–75%). The nonparetic limb also showed decreased extensor and flexor peak torque compared with the control group (17%–23%). Power showed similar deficits in strength (12%–78%). There were significant correlations between motor function and strength deficits (.54–.67).LimitationsMagnetic resonance imaging coil length did not allow measurement of the proximal region of the thigh.ConclusionsThere were different responses between quadriceps and hamstring muscle volumes in the paretic limb that had quadriceps muscle atrophy only. However, both paretic and nonparetic limbs showed knee extensor and flexor torque and power reduction.

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

Reference44 articles.

1. Incidence and characteristics of total stroke in the United States;Williams;BMC Neurology,2001

2. Epidemiology of cerebrovascular diseases in Brazil;Lessa;J Society Cardiology Sao Paulo State,1999

3. Treadmill training improves fitness reserve in chronic stroke patients;Macko;Arch Phys Med Rehabil,2001

4. Cardiovascular fitness after stroke: role of muscle mass and gait deficit severity;Ryan;J Stroke Cerebrovasc Dis,2000

5. Adaptive physical activity improves mobility function and quality of life in chronic hemiparesis;Macko;J Rehabil Res Dev,2008

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