Muscular Strengthening for Paretic Knee Flexor and Extensor by Conventional Physiotherapy on Chronic Hemiplegic Stroke Patients

Study Overview
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Brief Summary
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Gait impairment remain one of the main problem for hemiplegic stroke patients. After the 6 first months, stroke patients are classically described with moderate or no improvement. Here, we want to compare the effectiveness of a flexor and extensor paretic knee muscular strengthening program with conventional physiotherapy delivered by the local physiotherapist of the patient, in a very ecological way.

Detailed Description
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Gait impairment remain one of the main problem for most of chronic hemiplegic stroke patients. After the 6 first months, stroke patients are classically described with moderate or no improvement for motor skills. However, physiothertapy is very often delivered to try to increase motor performance. Here, we want to compare the effectiveness of a flexor and extensor paretic knee muscular strengthening program with conventional physiotherapy delivered by the local physiotherapist of the patient, in a very ecological way. Patients will be randomly affected to one group with the same amount of physiotherapy (at least 3 times weekly for 6 weeks). Assessment will be done blindly by another physiotherapist, before, after the 6-week treatment and 6 weeks later to evaluate immediate and remaining benefits of each treatment.

Official Title
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Muscular Strengthening for Paretic Knee Flexor and Extensor by Conventional Physiotherapy on Chronic Hemiplegic Stroke Patients

Conditions
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Hemiplegia, Stroke

Intervention / Treatment
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* Procedure: Muscular Strengthening for paretic knee flexor and extensor
* Other: conventional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hemipegia due to ischaemic or hemorrhagic stroke more than 6 months ago 1st and unique cerebral lesion (Xscan or MRI) ability to walk 15 m with or without cane or crutch able to understand and give approved consent quadriceps at 3/5 (MRC) or stronger Exclusion Criteria: Current treatment with botulinum toxin for spasticity of the paretic flexor or extensor of the knee Cardiovascular disease contra-indicating effort and strengthening Pregnancy Evolving pathology Rheumatic disease of the knee contraindicating strengthening Aphasia with severe comprehension impairment

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: group 1<br>Muscular Strengthening for paretic knee flexor and extensor | Procedure: Muscular Strengthening for paretic knee flexor and extensor<br>* thrice a week during 6 weeks<br>|
| Active Comparator: group 2<br>conventional physiotherapy | Other: conventional physiotherapy<br>* trice a week during 6 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gait comfortable speed |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| gait analysis (gait maximal speed, kymographic and dynamometric analysis, quality of gait parameter) FIM MOS-SF36 Spasticity (Tardieu Scale) |  | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, hemiplegia, gait, Strengthening, Physiotherapy