Impact of the difference in the plantar flexor strength of the ankle joint in the affected side among hemiplegic patients on the plantar pressure and walking asymmetry.
Young Youl You, Sin Ho Chung, Hyung Jin Lee
PMID 27942112WHAT IT FOUND
Stroke patients with weaker affected-side ankle plantar flexors showed greater walking asymmetry: shorter affected-side gait lines and lower affected-side forefoot and midfoot pressures than the unaffected side.
This was an observational comparison, not a treatment trial.
Key findings
01The zero-to-trace group had affected/nonaffected gait-line length values of 95.7 and 245.9, while the poor-to-fair group had 152.8 and 234.3.
02The zero-to-trace group had affected/nonaffected forefoot maximum pressure values of 10.2 and 24.5, and midfoot maximum pressure values of 8.5 and 14.3.
03Lateral symmetry was −31.4 ± 4.6 in the zero-to-trace group and −23.7 ± 7 in the poor-to-fair group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 30 patients who could already walk more than 10 meters without aids and had cognitive screening scores over 24, so it does not represent stroke patients with more severe walking or cognitive problems. It compared two strength groups after stroke; it did not randomise treatment or test a strengthening intervention, so it cannot show that plantar flexor strength caused the asymmetry. All patients were receiving traditional rehabilitation therapy, so any observed differences may be mixed with ongoing therapy. Measurements were taken on a treadmill at 1 to 2 km/hour without aids, so results may not apply to patients using canes or braces. The results table reports several gait and pressure values without units, so the size of the differences is hard to interpret clinically.
The easy way to misread this
Do not read these gait and pressure differences as proof that strengthening the affected-side plantar flexors will improve walking symmetry. This was an observational comparison of two strength groups, not a treatment trial.