Lower limb motor function and hip muscle weakness in stroke survivors and their relationship with pelvic tilt, weight-bearing asymmetry, and gait speed: A cross-sectional study

Background: Poor motor recovery of hip muscles affect the walking post-stroke. The study objective was to examine how lower extremity motor function and hip muscle weakness are related to weight-bearing asymmetry (WBA), excessive pelvic tilt, and gait speed in stroke survivors. Methods: Eighty patients with chronic stroke, a mean and standard deviation (SD) of post-stroke duration of 350 +/- 664 days, age of 30-70 years, independent standing, and 10-meter walking capacity participated in the study. Hip muscular strength was measured using a handheld dynamometer (HHD) and motor function was assessed by Fugl-Meyer Assessment of lower extremity (FMA-LE). The WBA was recorded using two weighing scales; whereas the pelvic tilt and gait speed were evaluated using palpation meter (PALM) and 10-meter walk test, respectively. Results: The muscles strength of hip flexors, extensors, abductors, and adductors of the paretic side ranged between 22.0 and 24.4 pounds. The mean score of FMA-LE was 22 points. Following Pearson product-moment correlation with statistically significant P < 0.05, the relationship of hip muscles strength and FMA with WBA, lateral pelvic tilt (LPT) and anterior pelvic tilt (APT), and speed are as follows: flexors (r = 0.47, r = 0.31, r = 0.44, r = 0.44), extensors (r = 0.45, r = 0.38, r = 0.37, r = 0.35), abductors (r = 0.49, r = 0.32, r = 0.38, r= 0.40), adductors (r = 0.45, r = 0.31, r = 0.23, r = 0.34), and motor function (r = 0.62, r = 0.33, r = 0.38, r = 0.62). Conclusion: Motor performance of the paretic lower limb was highly correlated with WBA and gait speed in stroke survivors. Overall hip muscle strength of paretic side had a moderate correlation with WBA, excessive pelvic tilt, and gait speed.