Michele Vecchio1, Jean-Michel Gracies2, Francesco Panza3, Francesca Fortunato4, Giovanna Vitaliti5, Giulia Malaguarnera6, Nicoletta Cinone7, Raffaele Beatrice7, Maurizio Ranieri7, Andrea Santamato8. 1. U.O. of Physical Medicine and Rehabilitation, Policlinico Vittorio Emanuele University Hospital, University of Catania, Catania, Italy. 2. EA 7377 BIOTN, Université Paris-Est, Albert Chenevier-Henri Mondor Hospital, Service de Rééducation Neurolocomotrice, AP-HP, Créteil, France. 3. U.O. of Physical Medicine and Rehabilitation, Policlinico Vittorio Emanuele University Hospital, University of Catania, Catania, Italy; Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy; Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy. Electronic address: geriat.dot@uniba.it. 4. Section of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy. 5. Institute of Pediatrics, Policlinico Vittorio Emanuele University Hospital, University of Catania, Catania, Italy. 6. Research Center "The Great Senescence," University of Catania, Catania, Italy. 7. "Physical Medicine and Rehabilitation" Unit, "OORR Hospital," University of Foggia, Foggia, Italy. 8. "Physical Medicine and Rehabilitation" Unit, "OORR Hospital," University of Foggia, Foggia, Italy; "Fondazione Turati" Rehabilitation Centre, Vieste, Foggia, Italy. Electronic address: andrea.santamato@unifg.it.
Abstract
BACKGROUND: In post-stroke patients, the possibility of performing an active ankle dorsiflexion movement is favorable for the recovery of gait. Moreover, the fatigue due to repetitive active ankle dorsiflexion could reduce the speed gait. We assessed the change in coefficient of fatigability of active ankle dorsiflexion after a home-based self-rehabilitative procedure in post-stroke patients. METHODS: In a prospective open-label observational study conducted in 2 university hospitals, a home-based self-rehabilitation treatment comprising two 12-minute sessions per day (3 times per week for 3 months) was performed by 10 outpatients with post-stroke lower limb impairment. Each session consisted of three 1-minute series of repeated active ankle dorsiflexion efforts at maximal speed on the paretic side, each one followed by 3-minute bouts of triceps surae stretch. Coefficients of fatigability of dorsiflexion and 10-meter barefoot ambulation speed were evaluated at baseline and at the end of the program. RESULTS: At 3 months of follow-up, there was a decrease in the coefficients of fatigability of ankle dorsiflexion, both with knee flexed and extended (respectively from 8% to 2% and from 6% to 2%; P < .01), associated with an increase in comfortable ambulation speed (from .24 to .26 m/s; P < .05). CONCLUSIONS: The reduction of coefficient of fatigability of ankle dorsiflexion, together with walking speed improvement, suggested the effectiveness of self-rehabilitation using alternated periods of self-stretch and rapid alternating efforts in the paretic lower limb after stroke.
BACKGROUND: In post-strokepatients, the possibility of performing an active ankle dorsiflexion movement is favorable for the recovery of gait. Moreover, the fatigue due to repetitive active ankle dorsiflexion could reduce the speed gait. We assessed the change in coefficient of fatigability of active ankle dorsiflexion after a home-based self-rehabilitative procedure in post-strokepatients. METHODS: In a prospective open-label observational study conducted in 2 university hospitals, a home-based self-rehabilitation treatment comprising two 12-minute sessions per day (3 times per week for 3 months) was performed by 10 outpatients with post-stroke lower limb impairment. Each session consisted of three 1-minute series of repeated active ankle dorsiflexion efforts at maximal speed on the paretic side, each one followed by 3-minute bouts of triceps surae stretch. Coefficients of fatigability of dorsiflexion and 10-meter barefoot ambulation speed were evaluated at baseline and at the end of the program. RESULTS: At 3 months of follow-up, there was a decrease in the coefficients of fatigability of ankle dorsiflexion, both with knee flexed and extended (respectively from 8% to 2% and from 6% to 2%; P < .01), associated with an increase in comfortable ambulation speed (from .24 to .26 m/s; P < .05). CONCLUSIONS: The reduction of coefficient of fatigability of ankle dorsiflexion, together with walking speed improvement, suggested the effectiveness of self-rehabilitation using alternated periods of self-stretch and rapid alternating efforts in the paretic lower limb after stroke.