NON-REFLEX MEDIATED CHANGES IN PLANTARFLEXOR MUSCLES EARLY AFTER STROKE

The aims of this study were to determine whether changes in the non-re flex component of spastic plantarflexors had developed 2 and 4 months after stroke and to study their relationship with the level of impairm ent, One group of adults with hemiparesis (HPs) was tested 2 and 4 mon ths after the onset of stroke, and data were compared with a control g roup (CTLs) tested once, Twenty-two patients (14 males) admitted over a 4-month period in a rehabilitation centre (mean = 62 yrs +/-14), and 11 (6 males) non-disabled (CTLs) subjects (mean = 57 yrs +/-12.8) agr eed to participate in the study, The resistive torque (RT) recorded wi th a myometer during slow (8-10 degrees/s) passive dorsiflexions impos ed manually served as the primary outcome, whereas, the Ashworth score (spasticity), ankle ROM and Fugl-Meyer motor subscore were used as se condary measures to determine the level of impairment. The mean RT val ues measured at 0 degrees dorsiflexion on the affected and unaffected sides were compared with those in CTLs, As expected, the RT values 2 a nd 4 months post-stroke on the unaffected side did not differ from cor responding values in CTLs, Significantly higher RT values on the affec ted side when compared to the unaffected side were found both at 2 mon ths (39%; p < 0.05) and at 4 months (43%; p < 0.01), No significant di fference existed on the affected side between the 2nd and 4th months, A high (r = 0.80) and significant (p < 0.0001) correlation coefficient was calculated between the changes in RT values recorded at 2 and 4 m onths, Low and not significant correlations were computed between thes e RT changes and factors such as the ROM (r = -0.24), the Ashworth sco re (r = 0.23) and the Fugl-Meyer lower extremity motor subscore (r = - 0.26), Present results indicate that: (1) changes in the non-reflex co mponent are already present 2 months after stroke but do not increase significantly between the 2nd and 4th months; (2) these changes are no t related to the level of impairment; and (3) myometry testing at 2 mo nths could be used as a preventive measure to detect patients more at risk of developing severe passive muscle stiffness.