Impact of Muscular Fatigability on Spastic Co-contractions After Stroke Patients

Study Overview
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Brief Summary
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This study evaluates the effects of an isokinetic fatigue protocol of the quadriceps on the amount of co-contractions of this last with the hamstrings during a maximal isometric flexion movement in hemiparetic stroke patients. The effect of such a protocol on gait parameters and spasticity of the quadriceps will be evaluated also.

Official Title
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Impact of Muscular Fatigability on Spastic Co-contractions Between the Quadriceps and Hamstrings in Stroke Patients

Conditions
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Stroke, Spasticity, Muscle, Muscle Fatigue, Gait, Hemiplegic

Intervention / Treatment
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* Procedure: Muscle fatigue


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 80y Hemiparesis after a first-ever stroke > 3 months Spasticity of the quadriceps muscle Quadriceps strength at least at 3/5 (MRC testing) Subject able to walk at least 2min without rest Informed consent Social security affiliation Exclusion Criteria: Severe comprehension troubles (language, cognitive or psychiatric disorders) History of previous stroke, locomotor or other neurological disorders Locomotor troubles affecting the paretic arm Contraindication to efforts : cardiac insufficiency, severe aortic valvular stenosis, recent heart failure, non treated high blood pressure, severe peripheral arterial disease Pregnancy or breastfeeding Adult subject to guardianship

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: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Quadriceps muscle fatigue<br>Quadriceps muscle fatigue | Procedure: Muscle fatigue<br>* Isokinetic quadriceps muscle fatigue of the paretic lower limb<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cocontraction Index (CCI) between the rectus femoris and the semitendinosus | ratio of the RMS of a the rectus femoris when acting as antagonist to the effort intended (knee flexion) to the RMS of the same muscle when acting as an agonist during a reciprocal maximal isometric knee flexion effort (500 ms around the peak of rectified EMG | one day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cocontraction Index (CCI) between the other parts of the quadriceps and the semitendinosus muscle | ratio of the RMS of a the vastus medialis, lateralis and intermedius when acting as antagonist to the effort intended (knee flexion) to the RMS of the same muscle when acting as an agonist during a reciprocal maximal isometric knee flexion effort (500 ms around the peak of rectified EMG | one day | 
| Agonist Recruitment Index of the semitendinosus | ratio of the RMS of a muscle acting as an agonist during a given period to its largest RMS value observed during the 500 ms around its agonist recruitment peak | one day | 
| Isometric peak knee flexion torque | Isometric peak knee flexion torque assessed by a CONTREX dynamometer | one day | 
| Spasticity of the quadriceps | Tardieu scale angle | one day | 
| spatio-temporal gait parameters at comfortable speed | Gait speed | one day | 
| spatio-temporal gait parameters at comfortable speed | Gait cadence | one day | 
| spatio-temporal gait parameters at comfortable speed | Step length | one day | 
| Isometric peak knee extension torque | Isometric peak knee extension torque assessed by a CONTREX dynamometer | one day | 
| 10 metre walk test (10MWT) | Assessment of max gait speed | one day | 
| 2 minute walk test (2MWT) | Assessment of max walking endurance | one day | 
| perceived exertion at the end of the 2MWT (Borg Scale 6-20) |  | one day |