Article

OBJECTIVE: To examine the influence of balance support on the energy cost of
treadmill and overground walking in ambulatory patients with stroke. DESIGN:
Cross-sectional. SETTING: Research laboratory at a rehabilitation center.
PARTICIPANTS: Patients with stroke depending on a walking aid in daily life
(n=12; walking aid dependent ambulators) and walking aid independent ambulators
(n=12), all able to walk for at least 5 minutes. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Energy cost (J.kg(-1).m(-1)) and temporal gait parameters
(walking speed, mean and coefficient of variation of stride time, and symmetry
index) were obtained during 4 walking trials at preferred walking speed:
overground with and without a cane and on a treadmill with and without handrail
support. RESULTS: On the treadmill, handrail support resulted in a significant
decrease in energy cost of 16%, independent of the group. Although walking aid
dependent ambulators had on average a larger reduction in energy cost than
walking aid independent ambulators (19% vs 14%), this interaction did not reach
statistical significance (P=.11). Interestingly, overground walking with support
resulted in an 8% reduction in energy cost for walking aid dependent ambulators,
but a 6% increase for walking aid independent ambulators. The reduction in energy
cost with support was accompanied by changes in temporal gait parameters, most
notably an increase in stride time and symmetry and a decrease in stride time
variability. CONCLUSIONS: Balance support can result in a significant reduction
in the energy cost of walking in stroke patients, the magnitude of which depends
on walking ability and the walking task. Impaired balance control should not be
overlooked as a contributing factor to the increased energy cost of walking in
patients with stroke, and improving or assisting balance control should be
considered to reduce the energy cost of hemiplegic gait.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS