Upper motor neuron lesions: Their effect on muscle performance and appearance in stroke patients with minor motor impairment

Objective: To evaluate muscular performance and appearance in patients with prior stroke who were ambulatory. Design: Nonrandomized study. Setting: University hospital laboratory. Subjects: Sixteen persons (11 men, 5 women) with minor motor impairments, 6 to 24 months after stroke, were included. As reference, data were used fro m a population-based sample of 144 men and women. Main Outcome Measurements: Muscle performance was evaluated using a Kin-Com dynamometer in both the affected and the nonaffected leg, Peak isometric s trength was measured at a 60 degrees angle in both extension and flexion, M aximal isokinetic strength was measured at 60 degrees/sec and at 180 degree s/sec. Endurance was evaluated during isometric and dynamic knee extensions . Muscle biopsies were taken on nine patients and muscle tissue areas were determined with computed tomography, Results: The affected leg was weaker but not different in relative enduranc e compared with the nonaffected side. The performance of the nonaffected si de was somewhat lower than that of a matched reference population. No major difference in fiber composition between the affected and nonaffected legs was noted, except for a lower degree of capillarization in the affected leg . Conclusion: In well-functioning stroke patients with good motor performance , further muscle training that includes resistance exercise might be indica ted. (C) 1999 by the American Congress of Rehabilitation Medicine and the A merican Academy of Physical Medicine and Rehabilitation.