Determining the cut-off value for knee extensor strength for identifying independence in gait in chronic stroke survivors.

OBJECTIVE: To determine the cut-off values for knee extensor strength on the paretic and non-paretic sides and both sides combined for identifying independence in gait in chronic stroke survivors.

DESIGN: Cross-sectional study.

PATIENTS: Sixty chronic stroke survivors.

METHODS: Functional Independence Measure (FIM) gait scores were measured, and the participants were allocated to the independent group (FIM gait score 6 or 7) or the dependent group (FIM gait score 1-5). Knee extensor strength on the paretic and non-paretic sides was measured using a handheld dynamometer.

RESULTS: Eighteen stroke survivors were allocated to the independent group and 42 to the dependent group. The receiver operating characteristic curve analyses revealed that the cut-off values for knee extensor strength were 0.46 Nm/kg (sensitivity 83% and specificity 67%; area under the curve (AUC) 0.816) on the paretic side, 0.65 Nm/kg (sensitivity 89% and specificity 55%; AUC 0.738) on the non-paretic side and 1.31 Nm/kg (sensitivity 83% and specificity 74%; AUC 0.811) for both sides combined.

CONCLUSION: These cut-off values could help to identify stroke survivors who are no longer independent in gait because of decreasing knee extensor strength on the paretic and non-paretic sides.