Effects of individualized lower limb isokinetic strengthening in clinical rehabilitation of older post-stroke patients: A retrospective study.
Lyne Daumas, Raphaël Zory, Axelle Garcia and 5 others
PMID 37548388WHAT IT FOUND
In older subacute stroke patients, adding individualized knee strengthening to physiotherapy and occupational therapy was associated with larger gains in independence and mobility.
The study was not randomised, so this is a possible benefit, not proof.
Key findings
01The Barthel Index rose from 61.59 to 88.18 in the isokinetic group and from 61.70 to 76.93 in the conventional group, and the change over time differed significantly between groups (p = 0.02).
02For the mobility subscore, the isokinetic group had a large effect size (d = 1.14) and the conventional group a small effect size (d = 0.35), with a significant group difference in change over time (p = 0.001).
03Spasticity on the Modified Ashworth Scale did not show a significant group difference, time change, or group difference in change over time.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and the groups were not randomised. The control group was made of patients who did not receive isokinetic strengthening because the ergometer was not available. Only patients able to transfer onto the ergometer and without severe transfer impairment or cognitive disorders that limited understanding were included. The results do not apply to more severely impaired stroke patients. Muscular outcomes were available only for the isokinetic group. Therefore, the study cannot compare muscle strength changes between the isokinetic and conventional groups. Some possible confounders, such as arthrosis, pain, and comorbidities, were not included in the analysis, and the duration of rehabilitation was not recorded. The groups improved overall on the Barthel Index, and the main finding was a time by group interaction rather than a significant overall group effect.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that isokinetic strengthening alone caused the functional gains. The isokinetic group also received conventional physiotherapy and occupational therapy, the groups were not randomised, and only patients able to transfer onto the ergometer were included. The study cannot separate the contribution of each component.