Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors

Munazza Shah; Ifrah Masood; Sidra Raza; Safeena Anar; Salman Farooqi

2026, Vol: 51, Issue: 2

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RMJ. 2026; 51(2): 528-532

Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors

Munazza Shah, Ifrah Masood, Sidra Raza, Safeena Anar, Salman Farooqi.

Abstract
Objectives: To explore the relationship between lower extremity muscle strength and walking efficiency in chronic stroke patients, focusing on energy cost of walking (ECW), gait speed, and walking endurance.
Methods: This cross-sectional study was conducted from June 2022 to July 2023 at a rehabilitation center and included 78 chronic stroke patients (stroke ≥6 months, age ≥18 years, able to walk 10 meters). Patients with walking pain, atrial fibrillation, or on beta/calcium channel blockers were excluded. The ECW in this study was quantified using the Physiological Cost Index (PCI)
Results: ECW showed a strong negative correlation with walking endurance (r = -0.71) and a moderate negative correlation with comfortable gait speed (CGS) (r = -0.61), both statistically significant (p<0.05). Walking endurance independently predicted ECW (r² = 37%), followed by lower limb muscle strength (r² = 27%) and CGS (r² = 25%).
Conclusion: Hip and knee muscle strength significantly affect energy cost, endurance, and gait speed post-stroke. Strengthening these muscles may improve walking efficiency and facilitate better mobility in stroke survivors.

Key words: Hemiplegia, activities, locomotor, difficulty walking, 6-minute walk test, muscle strength, oxygen consumption.

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How to Cite this Article

Pubmed Style

Shah M, Masood I, Raza S, Anar S, Farooqi S. Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. RMJ. 2026; 51(2): 528-532.

Web Style

Shah M, Masood I, Raza S, Anar S, Farooqi S. Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. https://www.rmj.org.pk/?mno=212071 [Access: June 22, 2026].

AMA (American Medical Association) Style

Shah M, Masood I, Raza S, Anar S, Farooqi S. Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. RMJ. 2026; 51(2): 528-532.

Vancouver/ICMJE Style

Shah M, Masood I, Raza S, Anar S, Farooqi S. Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. RMJ. (2026), [cited June 22, 2026]; 51(2): 528-532.

Harvard Style

Shah, M., Masood, . I., Raza, . S., Anar, . S. & Farooqi, . S. (2026) Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. RMJ, 51 (2), 528-532.

Turabian Style

Shah, Munazza, Ifrah Masood, Sidra Raza, Safeena Anar, and Salman Farooqi. 2026. Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors. Rawal Medical Journal, 51 (2), 528-532.

Chicago Style

Shah, Munazza, Ifrah Masood, Sidra Raza, Safeena Anar, and Salman Farooqi. "Exploring walking efficiency: A cross-sectional study of lower extremity muscle strength and performance in stroke survivors." Rawal Medical Journal 51 (2026), 528-532.

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