Rehabilitation and Therapy Commons^™

Oscillations In Neural Drive And Age-Related Reductions In Force Steadiness With A Cognitive Challenge, Hugo M. Pereira, Bonnie A. Schlinder-Delap Mrs., Kevin G. Keenan, Francesco Negro, Dario Farina, Allison S. Hyngstrom, Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

A cognitive challenge when imposed during a low-force isometric contraction will exacerbate sex- and age-related decreases in force steadiness, but the mechanism is not known. We determined the role of oscillations in the common synaptic input to motor units on force steadiness during a muscle contraction with a concurrent cognitive challenge. Forty-nine young adults (19–30 yr; 25 women, 24 men) and 36 old adults (60–85 yr; 19 women, 17 men) performed a cognitive challenge (counting backward by 13) during an isometric elbow flexion task at 5% of maximal voluntary contraction. Single-motor units were decomposed from high-density surface EMG recordings. For …

The Effect Of A Portable Electrical Muscle Stimulation Device At Home On Muscle Strength And Activation Patterns In Locomotive Syndrome Patients: A Randomized Control Trial, Yuichi Nishikawa, Kohei Watanabe, Shuhei Kawade, Tetsuya Takahashi, Hiroaki Kimura, Hirofumi Maruyama, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of the present study was to quantify the effect of electrical muscle stimulation (EMS) intervention using a portable device on muscle strength and activation patterns in locomotive syndrome. Nineteen women were randomly assigned to the intervention group (n = 10; age = 71–82 years) and control group (n = 9; age = 70–84 years). Participants in the intervention group used a portable EMS device to stimulate the bilateral quadriceps muscles for 8 weeks (23 min/5 days/week). To understand the effects of EMS, the following measurements were made at baseline, 8 weeks, and 12 weeks: locomotive syndrome assessment score, …

Fatiguing Trunk Flexor Exercise Decreases Pain Sensitivity In Postpartum Women, Rita Deering, Tatyana Pashibin, Meredith Cruz, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background: Low back pain (LBP) is common in the general population and among postpartum women. Abdominal muscle exercise is often used to treat LBP, but it is unknown if fatiguing abdominal muscle exercise can produce exercise-induced hypoalgesia (EIH).

Objectives: To assess pressure pain thresholds (PPTs) at rest and following fatiguing trunk flexor exercise (EIH) in (1) nulligravid and postpartum women to evaluate the impact of pregnancy and childbirth and (2) nulligravid women and men to examine sex differences.

Methods: Seventy healthy adults (31 postpartum women, 23 nulligravid women, 16 men) participated. Postpartum and nulligravid women were tested twice (16–18 weeks …

Incremental Clinical Effectiveness And Cost Effectiveness Of Providing Supervised Physiotherapy In Addition To Usual Medical Care In Patients With Osteoarthritis Of The Hip Or Knee: 2-Year Results Of The Moa Randomised Controlled Trial, J. H. Abbott, R Wilson, Daniel Pinto, C. M. Chapple, A. A. Wright

Physical Therapy Faculty Research and Publications

Objective

To investigate the clinical- and cost-effectiveness at 2-year follow-up of providing individual, supervised exercise physiotherapy and/or manual physiotherapy in addition to usual medical care.

Method

People with hip or knee osteoarthritis meeting the American College of Rheumatology clinical diagnostic criteria were randomised (1:1, concealed, assessor-blinded) to four groups: usual medical care; supervised exercise physiotherapy; manual physiotherapy; or combined exercise and manual physiotherapy. Physiotherapy group participants were provided 10 50-min treatment sessions including booster sessions at 4 and 13 months, in addition to usual care. The primary outcome at 2-year follow-up was incremental cost-utility ratio (ICUR) of each physiotherapy intervention …

Two Weeks Of Ischemic Conditioning Improves Walking Speed And Reduces Neuromuscular Fatigability In Chronic Stroke Survivors, Matthew J. Durand, Timothy F. Boerger, Jennifer Nguyen, Saad Z. Alqahtani, Michael T. Wright, Brian D. Schmit, David D. Gutterman, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

This pilot study examined whether ischemic conditioning (IC), a noninvasive, cost-effective, and easy-to-administer intervention, could improve gait speed and paretic leg muscle function in stroke survivors. We hypothesized that 2 wk of IC training would increase self-selected walking speed, increase paretic muscle strength, and reduce neuromuscular fatigability in chronic stroke survivors. Twenty-two chronic stroke survivors received either IC or IC Sham on their paretic leg every other day for 2 wk (7 total sessions). IC involved 5-min bouts of ischemia, repeated five times, using a cuff inflated to 225 mmHg on the paretic thigh. For IC Sham, the cuff inflation …

Preferences For Physical Activity: A Conjoint Analysis Involving People With Chronic Knee Pain, Daniel Pinto, Ulf Bockenholt, Jungwha Lee, Rowland W. Chang, Leena Sharma, Daniel J. Finn, Allen W. Heinemann, Jane Louise Holl, Paul D. Hansen

Physical Therapy Faculty Research and Publications

Objective

To investigate individual preferences for physical activity (PA) attributes in adults with chronic knee pain, to identify clusters of individuals with similar preferences, and to identify whether individuals in these clusters differ by their demographic and health characteristics.

Design

An adaptive conjoint analysis (ACA) was conducted using the Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA) method to determine preference weights representing the relative importance of six PA attributes. Cluster analysis was performed to identify clusters of participants with similar weights. Chi-square and ANOVA were used to assess differences in individual characteristics by cluster. Multinomial logistic regression was …

Ballroom Dance For Persons With Multiple Sclerosis: A Pilot Feasibility Study, Alexander V. Ng, Sheri Bunyan, Jimin Suh, Pamela Huenink, Tyler Gregory, Shannon Gambon, Deborah Miller

Exercise Science Faculty Research and Publications

Purpose: The purpose of this study was to evaluate the exercise intensity and feasibility of recreational ballroom dance for persons with multiple sclerosis (MS).

Methods: Seven persons with MS participated in 2 one-hour dance sessions per week for 6 weeks. Dance types included rumba, foxtrot, waltz, and push-pull. Six other persons with MS comprised a control group that did not dance. Heart rate and ratings of perceived exertion (RPE) were monitored during the sessions. Outcomes included: quality of life, fatigue, depression, self-efficacy, timed up and go, Berg Balance Scale, Dynamic Gait Index and the Multiple Sclerosis Functional Composite comprising 9-hole …

A Substruction Approach To Assessing The Theoretical Validity Of Measures, Polly Ryan, Marianne E. Weiss, Paula E. Papanek

Exercise Science Faculty Research and Publications

Background

Validity is about the logic, meaningfulness, and evidence used to defend inferences made when interpreting results. Substruction is a heuristic or process that visually represent the hierarchical structure between theory and measures.

Purpose

To describe substruction as a method for assessing the toretical validity of research measures.

Methods

Using Fawcett's Conceptual-Theoretical-Empirical Structure. an exemplar is presented of substruction from the Individual and Family Self-Management Theory to the Striving to be strong study concepts and empirical measures.

Results

Substruction tables display evidence supporting theoretical validity of the instruments used in the study.

Conclusion

A high degree of congruence between theory …

Brain Activation During Passive And Volitional Pedaling After Stroke, Brice T. Cleland, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

Background: Prior work indicates that pedaling-related brain activation is lower in people with stroke than in controls. We asked whether this observation could be explained by between-group differences in volitional motor commands and pedaling performance. Methods: Individuals with and without stroke performed passive and volitional pedaling while brain activation was recorded with functional magnetic resonance imaging. The passive condition eliminated motor commands to pedal and minimized between-group differences in pedaling performance. Volume, intensity, and laterality of brain activation were compared across conditions and groups. Results: There were no significant effects of condition and no Group × Condition …

Patients’ Preferences For Osteoarthritis Treatment: The Value Of Stated-Preference Studies, Mickael Hiligsmann, Daniel Pinto, Elaine Dennison, Nasser Al-Daghri, Charlotte Beaudart, Jaime Branco, Olivier Bruyère, Philip G. Conaghan, Cyrus Cooper, Gabriel Herrero-Beaumont, Famida Jiwa, Willem Lems, Thierry Thomas, Nicola Veronese, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

No abstract provided.

Clinical Decision-Making For Thrombolysis Of Acute Minor Stroke Using Adaptive Conjoint Analysis, Ava L. Liberman, Daniel Pinto, Sara K. Rostanski, Daniel L. Labovitz, Andrew M. Naidech, Shyam Prabhakaran

Physical Therapy Faculty Research and Publications

Introduction:

There is practice variability in the treatment of patients with minor ischemic stroke with thrombolysis. We sought to determine which clinical factors physicians prioritize in thrombolysis decision-making for minor stroke using adaptive conjoint analysis.

Methods:

We conducted our conjoint analysis using the Potentially All Pairwise RanKings of all possible Alternatives methodology via the 1000Minds platform to design an online preference survey and circulated it to US physicians involved in stroke care. We evaluated 6 clinical attributes: language/speech deficits, motor deficits, other neurological deficits, history suggestive of increased risk of complication from thrombolysis, age, and premorbid disability. Survey participants were …

A Principal Components Analysis Approach To Quantifying Foot Clearance And Foot Clearance Variability, Lauren C. Benson, Stephen C. Cobb, Allison S. Hyngstrom, Kevin G. Keenan, Jake Luo, Kristian M. O'Connor

Physical Therapy Faculty Research and Publications

Low foot clearance and high variability may be related to falls risk. Foot clearance is often defined as the local minimum in toe height during swing; however, not all strides have this local minimum. The primary purpose of this study was to identify a nondiscrete measure of foot clearance during all strides, and compare discrete and nondiscrete measures in ability to rank individuals on foot clearance and variability. Thirty-five participants (young adults [n = 10], older fallers [n = 10], older nonfallers [n = 10], and stroke survivors [n = 5]) walked overground while lower extremity 3D kinematics were recorded. …

Recommendations For The Conduct Of Economic Evaluations In Osteoporosis: Outcomes Of An Experts’ Consensus Meeting Organized By The European Society For Clinical And Economic Aspects Of Osteoporosis, Osteoarthritis And Musculoskeletal Diseases (Esceo) And The Us Branch Of The International Osteoporosis Foundation, M. Hiligsmann, J.-Y. Reginster, A.N.A. Tosteson, S.V. Bukata, K.G. Saag, D.T. Gold, P. Halbout, F. Jiwa, E.M. Lewiecki, Daniel Pinto, J.D. Adachi, N. Al-Daghri, O. Bruyère, M. Chandran, C. Cooper, N.C. Harvey, T.A. Einhorn, J.A. Kanis, D.L. Kendler, O.D. Messina, R. Rizzoli, L. Si, S. Silverman

Physical Therapy Faculty Research and Publications

Summary

Economic evaluations are increasingly used to assess the value of health interventions, but variable quality and heterogeneity limit the use of these evaluations by decision-makers. These recommendations provide guidance for the design, conduct, and reporting of economic evaluations in osteoporosis to improve their transparency, comparability, and methodologic standards.

Introduction

This paper aims to provide recommendations for the conduct of economic evaluations in osteoporosis in order to improve their transparency, comparability, and methodologic standards.

Methods

A working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis to make recommendations for the design, conduct, …

Identifying Trippers And Non-Trippers Based On Knee Kinematics During Obstacle-Free Walking, Lauren C. Benson, Stephen C. Cobb, Allison S. Hyngstrom, Kevin G. Keenan, Jake Luo, Kristian M. O'Connor

Physical Therapy Faculty Research and Publications

Trips are a major cause of falls. Sagittal-plane kinematics affect clearance between the foot and obstacles, however, it is unclear which kinematic measures during obstacle-free walking are associated with avoiding a trip when encountering an obstacle. The purpose of this study was to determine kinematic factors during obstacle-free walking that are related to obstacle avoidance ability. It was expected that successful obstacle avoidance would be associated with greater peak flexion/dorsiflexion and range of motion (ROM), and differences in timing of peak flexion/dorsiflexion during swing of obstacle-free walking for the hip, knee and ankle. Three-dimensional kinematics were recorded as 35 participants …

Force Steadiness During A Cognitively Challenging Motor Task Is Predicted By Executive Function In Older Adults, Hugo M. Pereira, Bonnie A. Schlinder-Delap Mrs., Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Motor performance and cognitive function both decline with aging. Older adults for example are usually less steady for a constant-force task than young adults when performing low-intensity contractions with limb muscles. Healthy older adults can also show varying degrees of cognitive decline, particularly in executive function skills. It is not known, however, whether age-related changes in steadiness of low-force tasks and cognitive function are independent of one another. In this study, we determined if executive function skills in aging are associated with the steadiness during a low-force muscle contraction performed with and without the imposition of a cognitive challenge. We …

Knee Extensor Fatigability During Different Resistance Exercise Protocols In Young And Old Adults, Jose Delgadillo

Master's Theses (2009 -)

Aging is associated with decreased muscle strength, power, and contraction velocity, and increased fatigability of the lower limb muscles during dynamic contractions. The aims of this thesis were to compare young in and old men and women in: (1) fatigability of the knee extensors for two types of dynamic fatiguing protocols that are the basis of resistance training protocols, and (2) the central and peripheral mechanisms of fatigue during the two types of dynamic fatiguing protocols. Twenty young (19-24, 22.2 ± 1.3 years, men = 10) and twenty old adults (64-85, 73.8 ± 5.4, men = 10) performed: two different …

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need, D. Agrawal, Mark Kern, F. Edeani, Gokulakrishnan Balasubramanian, Allison S. Hyngstrom, Patrick Sanvanson, Rita Shaker

Physical Therapy Faculty Research and Publications

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy …

Home-Based, Square-Stepping Exercise Program Among Older Adults With Multiple Sclerosis: Results Of A Feasibility Randomized Controlled Study, Emerson Sebastião, Edward Mcauley, Ryosuke Shigematsu, Brynn C. Adamson, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an …

Experience Of Robotic Exoskeleton Use At Four Spinal Cord Injury Model Systems Centers, Allen W. Heinemann, Arun Jayaraman, Chaithanya K. Mummidisetty, Jamal Spraggins, Daniel Pinto, Susan Charlifue, Candy Tefertiller, Heather B. Taylor, Shuo-Hsiu Chang, Argyrios Stampas, Catherine L. Furbish, Edelle C. Field-Fote

Physical Therapy Faculty Research and Publications

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians' experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians' perceptions of exoskeleton benefits and risks and developments that would enhance utility.

Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions.

Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used …

Locomotor Adaptations To Prolonged Step-By-Step Frontal Plane Trunk Perturbations In Young Adults, Eric R. Walker, Allison S. Hyngstrom, Tanya Onushko, Brian D. Schmit

Physical Therapy Faculty Research and Publications

The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Healthy young participants (n = 10, 5 female) walked on an instrumented split-belt treadmill while an external cable-driven device applied frontal plane forces to the trunk. Two types of forces were applied: 1) forces which accentuated COM movement in the frontal plane (destabilizing) and 2) forces which resisted COM movement in the frontal plane (stabilizing). We quantified dynamic balance control using frontal plane measures of (1) the extent of center …

Lean Mass Mediates The Relation Between Temporal Summation Of Pain And Sex In Young Healthy Adults, Abdulaziz Awali, Ali Alsouhibani, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition.

Methods

Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject …

Gait Variability And Energy Cost Of Overground Walking In Persons With Multiple Sclerosis: A Cross-Sectional Study, Emerson Sebastião, Rachel E. Bollaert, Elizabeth A. Hubbard, Robert W. Motl

Exercise Science Faculty Research and Publications

Objective: This study examined the associations between gait variability based on common spatiotemporal parameters and energetic cost of walking in persons with multiple sclerosis.

Design: Eighty-six persons with multiple sclerosis underwent the 6-min walk while wearing a portable metabolic unit. The cost of walking was generated by dividing the net steady-state VO₂ (milliliter per kilogram per minute) by walking speed during the 6-min walk. Participants further completed two trials of walking on the GAITRite mat at a self-selected pace for measuring spatiotemporal parameters. Variability of step length, step time, stride length, swing time, stance time, stride velocity, and single- …

Exercise-Induced Pain And Analgesia? Underlying Mechanisms And Clinical Translation, Kathleen A. Sluka, Laura Frey-Law, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.

Phase-Iii, Randomized Controlled Trial Of The Behavioral Intervention For Increasing Physical Activity In Multiple Sclerosis: Project Bipams, Robert W. Motl, Brian M. Sandroff, Brooks C. Wingo, Justin Mccroskey, Lara A. Pilutti, Gary R. Cutter, Rachel E. Bollaert, Edward Mcauley

Exercise Science Faculty Research and Publications

Background

We propose a phase-III, randomized controlled trial (RCT) that examines the effectiveness of a behavioral intervention based on social cognitive theory (SCT) and delivered through the Internet using e-learning approaches for increasing physical activity and secondary outcomes (e.g., symptoms) in a large sample of people with multiple sclerosis (MS) residing throughout the United States.

Methods/design

The proposed phase-III trial will use a parallel group, RCT design that examines the effect of a 6-month behavioral intervention for increasing physical activity and secondarily improving mobility, cognition, symptoms, and quality of life (QOL) in persons with MS. The primary outcome is accelerometer-measured …

Associations Of Functional Connectivity And Walking Performance In Multiple Sclerosis, Rachel E. Bollaert, Kyle Poe, Elizabeth A. Hubbard, Robert W. Motl, Lara A. Pilutti, Curtis L. Johnson, Bradley P. Sutton

Exercise Science Faculty Research and Publications

Background

Persons with multiple sclerosis (MS) often demonstrate impaired walking performance, and neuroimaging methods such as resting state functional connectivity. (RSFC) may support a link between central nervous system damage and disruptions in walking.

Objectives

This study examined associations between RSFC in cortical networks and walking performance in persons with MS.

Methods

29 persons with MS underwent 3-T brain magnetic resonance imaging (MRI) and we computed RSFC among 68 Gy matter regions of interest in the brain. Participants completed the Timed 25-foot Walk as a measure of walking performance. We examined associations using partial Pearson product-moment correlation analyses (r …

Motor Compensation During Lower Limb Pedaling After Stroke, Brice Thomas Cleland

Dissertations (1934 -)

Long-term motor dysfunction in the lower limb is common after stroke. One potential contributor is motor compensation, a behavior in which functions originally performed by the paretic limb are performed by the non-paretic limb. Compensation in chronic stroke may contribute to long-term motor dysfunction by limiting functional ability, impairing future recovery, and eliciting maladaptive neuroplasticity. The purpose of this dissertation was to describe the impact of compensation on motor function and brain activation during lower limb pedaling and identify elements that produce this behavior. To achieve this purpose, we evaluated muscle activation and motor performance when compensation was prevented. During …

Total Energy Expenditure And Body Composition Of Children With Developmental Disabilities, Michele L. Polfuss, Kathleen J. Sawin, Paula E. Papanek, Linda Bandini, Bethany Forseth, Andrea Moosreiner, Kimberley Zvara, Dale A. Schoeller

Exercise Science Faculty Research and Publications

Background

Obesity prevalence is increased in children with developmental disabilities, specifically in children with spina bifida and Down syndrome. Energy expenditure, a critical aspect of weight management, has been extensively studied in the typically developing population, but not adequately studied in children with developmental disabilities.

Objective

Determine energy expenditure, fat-free mass and body fat percentile and the impact of these findings on recommended caloric intake in children with spina bifida and Down syndrome.

Methods/Measures

This pilot study included 36 children, 18 with spina bifida, 9 with Down syndrome and 9 typically developing children. Half of the children with spina bifida …

Change In Bone Mineral Density Among High Frequency Apheresis Blood Donors, Walter Bialkowski

Dissertations (1934 -)

Exposure to citrate anticoagulant during apheresis blood donation induces significant decreases in serum ionized calcium with subsequent perturbations to parathyroid hormone, vitamin D, and markers of bone remodeling. Cross-sectional studies of bone mineral density (BMD) among apheresis donors exhibit conflicting results. Resolving the potential impact of the highest apheresis donation frequency represents a significant knowledge gap in ensuring adequate protections for volunteer apheresis blood donors. ALTRUYST (NCT02655055) was a randomized, longitudinal, controlled clinical trial designed to determine if repeated exposure to citrate through apheresis donation reduces BMD. Male donors, 18-65 years of age with no more than five previous apheresis …

Sex Differences In Mechanisms Of Recovery After Isometric And Dynamic Fatiguing Tasks, Jonathon Senefeld, Hugo M. Pereira, Nicholas Elliott, Tejin Yoon, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose The purpose of this study was to determine whether supraspinal mechanisms contribute to the sex difference in fatigability during and recovery from a dynamic and isometric fatiguing task with the knee extensors.

Methods: Transcranial magnetic stimulation and electrical stimulation were used to determine voluntary activation and contractile properties of the knee extensors in 14 men and 17 women (20.8 ± 1.9 yr) after a 1) 60-s sustained, maximal voluntary isometric contraction (MVIC), and 2) dynamic fatiguing task involving 120 maximal voluntary concentric contractions with a 20% MVIC load.

Results: There were no differences between men and women in the …

Ischemic Conditioning Increases Strength And Volitional Activation Of Paretic Muscle In Chronic Stroke: A Pilot Study, Allison S. Hyngstrom, Spencer A. Murphy, Jennifer Nguyen, Brian D. Schmit, Francesco Negro, David D. Gutterman, Matthew J. Durand

Physical Therapy Faculty Research and Publications

Ischemic conditioning (IC) on the arm or leg has emerged as an intervention to improve strength and performance in healthy populations, but the effects on neurological populations are unknown. The purpose of this study was to quantify the effects of a single session of IC on knee extensor strength and muscle activation in chronic stroke survivors. Maximal knee extensor torque measurements and surface EMG were quantified in 10 chronic stroke survivors (>1 yr poststroke) with hemiparesis before and after a single session of IC or sham on the paretic leg. IC consisted of 5 min of compression with a …