Effect of isokinetic hip flexors strength training on walking in persons with subacute stroke: Feasibility study

Objective Use of isokinetic muscle strengthening is spreading in neurological rehabilitation, especially to improve gait in stroke patients. However, contrary to ankle and knee muscles, hip flexors strengthening stay few investigated in this population. The aim of our study was to determine the feasibility and the effects of an isokinetic training of paretic hip flexors on several gait parameters (gait speed and endurance, perceived exertion), muscle strength (ilio-psoas), spasticity and also balance, transfers and stair-climbing abilities. Material/patients and methods Twelve hemiparetic participants who had suffered from a first episode of stroke were randomized into two groups during a fifteen months period. During six weeks, the control group benefited from ten usual physiotherapy sessions each week, whereas the experimental group undertook the same number of physiotherapy sessions but three of those were dedicated to isokinetic exercises. The Con-Trex Isokinetic Dynamometer was used to perform eccentric hip flexors strengthening sessions. Analytic and functional assessments were carried out at the inclusion time (T0) and after six weeks of rehabilitation (T1). Results Our early results highlighted a significant improvement for the primary endpoint (ten meters walking test) for the experimental group only ( P  = 0.028) and for most of the secondary endpoints of this group, except the peak torque ( P  = 0.463) and the power of paretic hip flexors ( P  = 0.249). Discussion – conclusion These early results seem to indicate a beneficial effect of isokinetic hip flexors strengthening protocol in subacute stroke gait rehabilitation. Those results must be confirmed in further studies.