Article

Impaired economy of gait, prevalent in chronic stroke secondary to
residual gait deficits, is associated with intolerance for performing activities
of daily living. Gait economy/efficiency is traditionally assessed by determining
the rate of oxygen consumption during submaximal treadmill walking. However, the
mechanics and energetics of treadmill versus overground walking are very
different in stroke survivors with ambulatory deficits.
Clearly, overground
cardiopulmonary measures are needed to accurately profile movement economy after
stroke. An obstacle to obtaining such measures after stroke has been the absence
of reliable portable metabolic monitoring equipment. The purpose of this study
was to establish the test-retest reliability of a portable metabolic monitoring
device during overground walking in hemiparetic stroke survivors. METHODS:
Twenty-three chronic hemiparetic stroke survivors underwent two 6-minute walk
tests while wearing a COSMED K4b(2) portable metabolic measurement system.
Intraclass correlations coefficients (ICC) were calculated for both
cardiopulmonary parameters and distance covered to determine test-retest
reliability. An ICC of >/= 0.85 was considered reliable. RESULTS: ICCs for
relative Vo2 (0.90), absolute Vo2 (0.93), Vco2 (0.93), and minute ventilation
(0.95) demonstrated high reliability, but not for heart rate (0.76) or
respiratory exchange ratio (0.64). There was no significant difference in the
distance each participant walked between the first and second tests, eliminating
distance as a potential confounder of our analyses (ICC = 0.99). CONCLUSIONS: Our
results strongly support the reliability of the K4b(2) for quantifying overground
gait efficiency after stroke. Use of this device may enable researchers to study
how varying poststroke rehabilitation interventions affect this central measure
of health and function.

Langue : ANGLAIS