Metabolic Cost of Overground Gait in Younger Stroke Patients and Healthy Controls

Purpose: Locomotor impairment, such as that which may occur following a stroke, results in increased energy expenditure during walking. Previous research quantifying this increased metabolic demand has focused on older people; thus, the aim of this study was to investigate the physiological cost of walking in younger patients following stroke. Methods: Thirteen stroke patients (mean age of 40.7 ± 10.0 yr) and 13 age- and sex-matched controls participated. Each subject walked for 5 min around an elliptical course (two cones set 9.5 m apart) at their own preferred walking speed (PWS). The percentage of expired oxygen was measured using a portable gas analyzer. Following a 5-min rest, the control subjects repeated the procedure, but at the PWS of the patient to whom they were matched. Results: The PWS of the stroke patients was significantly lower than that of the controls (P < 0.001); however, there was no significant difference in terms of oxygen uptake (P = 0.403). When the distance walked was considered, there was a statistically significant difference in oxygen uptake per unit of distance between the two groups (P < 0.001) and also between the patients PWS and the controls walking at the PWS of the patients. Conclusion: The high metabolic cost of walking would suggest that, even for younger stroke patients, early rehabilitation should consider aerobic evaluation and training with the aim of optimizing functional independence.

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