Article

OBJECTIVES: To systematically review the evidence to determine energy expenditure
(EE) in volume of oxygen uptake (V o2) (mL/kg/min) and energy cost in oxygen
uptake per meter walked
(V o2/walking speed; mL/kg/m) during walking poststroke
and how it compares with healthy controls; and to determine how applicable
current exercise prescription guidelines are to stroke survivors. DATA SOURCES:
Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL were
searched on October 9, 2014, using search terms related to stroke and EE.
Additionally, we screened reference lists of eligible studies. STUDY SELECTION:
Two independent reviewers screened titles and abstracts of 2115 identified
references. After screening the full text of 144 potentially eligible studies, we
included 29 studies (stroke survivors: n=501, healthy controls: n=123), including
participants with confirmed stroke and a measure of V o2 during walking using
breath-by-breath analysis. Studies with (9 studies) and without (20 studies) a
healthy control group were included. DATA EXTRACTION: Two reviewers independently
extracted data using a standard template, including patient characteristics,
outcome data, and study methods. DATA SYNTHESIS: Mean age of stroke survivors was
57 years (range, 40-67y). Poststroke EE was highly variable across studies and
could not be pooled because of high heterogeneity. EE during steady-state
overground walking at matched speeds was significantly higher in stroke survivors
than healthy controls (mean difference in V o2, 4.06 mL/kg/min; 95% confidence
interval [CI], 2.21-5.91; 1 study; n=26); there was no significant group
difference at self-selected speeds. Energy cost during steady-state overground
walking was higher in stroke survivors at both self-selected (mean difference,
.47 mL/kg/m; 95% CI, .29-.66; 2 studies; n=38) and matched speeds compared with
healthy controls (mean difference, .27 mL/kg/m; 95% CI, .03-.51; 1 study; n=26).
CONCLUSIONS: Stroke survivors expend more energy during walking than healthy
controls. Low-intensity exercise as described in guidelines might be at a
moderate intensity level for stroke survivors; there is a need for
stroke-specific exercise guidelines.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS