Isokinetic strength training of lower limb muscles following acquired brain injury.

PRIMARY OBJECTIVE: To investigate the effectiveness of isokinetic strength training of ankle and knee muscles in adults with chronic acquired brain injury (ABI). RESEARCH DESIGN: Series of single case studies. METHODS: Twelve people with ABI participated in a 2.5-week baseline, 12-week intervention and a 4-week follow-up phase. INTERVENTION: Concentric isokinetic exercise, twice a week, for plantarflexors (PFs), dorsiflexors (DFs), knee flexors (KFs) and knee extensors (KEs). OUTCOMES: Peak torque and power at 60 and 90° s⁻¹, PFs and KFs tone at 60° s⁻¹, gait speed and timed chair rises. RESULTS: For single case analyses strength improvements were noted in 11/12 participants' PFs, 5/12 participants' DFs and 7/12 participants' KEs and KFs. Gait speed improved in 8/12 participants and chair rise time improved in 7/12 participants. PFs tone increased in three participants, KFs tone increased in six participants and three participants reported knee pain. For group analyses, peak torque of PFs and KEs, fast gait speed and timed chair rises demonstrated improvement (p < 0.05). CONCLUSIONS: Isokinetic strength training may be effective to improve lower limb muscle strength; however, care needs to be taken in selecting suitable candidates as some individuals reported knee pain with this intensive programme.

Bilateral femoral rotations measured during walking: a new parameter to summarize and describe individual gait.

The aim of this study was to develop and assess a method of analysis of femoral rotations to describe and summarize an individual's gait. Twelve normal subjects underwent walking trials at both natural and slow speeds, controlled by a metronome. The three-dimensional rotations of each femur were measured, simultaneously, during walking using a 3SPACE Tracker. The phase lags between the three rotations for each leg, obtained by cross-correlations, provided the primary data. The device was found to be reliable and gave significant test--retest repeatability. The analyses provided summary parameters describing mathematically the patterns of rotations and showed there was repeatability within and between sessions. A strong systematic subject effect in all analyses indicated that these parameters provide a highly specific description of how an individual walks.