Is the Assessment of the Non-Paretic Lower Limb in Patients After Stroke Important When Planning Rehabilitation?

(1)

Background

Hemiparetic patients after stroke have deficits on the side of the body opposite to the brain lesion. The aim of this study is to assess the occurrence of deficits in the ipsilesional lower limb. (2)

Methods

Twenty-nine stroke patients (SG) and 29 healthy volunteers (CG) were recruited for this study. Passive (PROM), active (AROM), fast range of motion (FROM), and joint position sense (JPS) in the knee joint were measured using a wireless motion system. Participants were also assessed using the step test, balance platform, and the isometric protocol of measuring the strength of the extensor and flexor muscles of the knee. We compared non-paretic lower limb outcomes to the paretic side and a control group. (3)

Results

The results showed a difference between the results of the ipsilesional side of the body of stroke patients and the control group. In the non-paretic limb, we observed deficits in PROM (p = 0.018) and AROM (p = 0.048), a lower average (p < 0.001) and maximum speed (p < 0.001) in FROM, worse proprioception (JPS, p < 0.001), and a lower number of repetitions in the step test (p < 0.001) compared to the control group. We also observed a decrease in the average isometric strength of the extensor (p < 0.001) and flexor (p = 0.040) muscles of the non-paretic knee joint compared to the CG. The balance assessment on a balance platform showed worse postural control in people after stroke in all tested conditions (eyes open and closed on a firm and foam surface; p < 0.001). (4)

Conclusions

The non-paretic lower limb in stroke patients is characterized by limited ROM at the knee joint, reduced movement speed, decreased proprioception, weakness of the knee flexors and extensors, and resulting impaired balance. The deficits identified require improvement and should be considered when planning rehabilitation.