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Muscle Impairments and Behavioral Factors Mediate Functional Limitations and Disability Following Stroke

NK LeBrasseur, PT, PhD, was a doctoral candidate, Human Physiology Laboratory, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Mass, at the time of the study and is currently Assistant Professor of Medicine, Boston University School of Medicine, 670 Albany St, Rm 218, Boston, MA 02118 (USA)
SP Sayers, PhD, is Assistant Professor, Department of Physical Therapy, School of Health Professions, University of Missouri–Columbia, Columbia, Mo
MM Ouellette, PT, MSPT, is Research Associate, Human Physiology Laboratory, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University
RA Fielding, PhD, was Associate Professor and Director, Human Physiology Laboratory, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, at the time of the study and is currently Director and Scientist I, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Mass

Address all correspondence to Dr LeBrasseur at: nlebrass{at}bu.edu

Background and Purpose. Stroke remains the leading cause of disability in the United States. The purposes of this study were to examine whether quantitative measures of muscle strength and power in the involved lower extremity predict functional limitations and to evaluate the contributions of behavioral factors to mediating disability and quality of life in people who have survived a stroke. Subjects and Methods. A cross-sectional study design was used, and measurements of muscle impairment, lower-body function, disability, quality of life, and behavioral factors were obtained for 31 community-dwelling volunteers who had experienced a single ischemic stroke in the past 6 to 24 months. Results. Stepwise regression models including impairment and behavioral measures were strong predictors of function, disability, and quality of life. Involved-extremity muscle strength and power and self-efficacy were independently associated with function, whereas depression and self-efficacy were strong predictors of disability and quality of life. Discussion and Conclusion. The findings warrant future studies to determine whether interventions that address muscle strength and power, depressive symptoms, and low self-efficacy effectively improve function, reduce disability, and enhance quality of life in people who have survived a stroke.

Key Words: Cerebrovascular accident • Power • Quality of life • Self-efficacy • Strength

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