Article

Two common impairments in patients after stroke are loss of balance control and
fatigue. We propose that both could be inter-related. The purpose of this study
was to investigate the metabolic energy demand for balance control in patients
after stroke during upright standing. Ten stroke patients and 12 able-bodied
controls performed four 5-min upright standing tasks on a force plate;
unperturbed (SU), blindfolded (SUB), on foam surface (SUF) and with feet parallel
against each other (SUP). Metabolic energy expenditure, posturography measures
and muscle activity (EMG) of lower leg muscles were measured. Patients required
on average 125% (33Jkg(-1)s(-1)) more metabolic energy for upright standing under
the various conditions than controls. In addition, balance manipulation
significantly (p<0.05) affected energy expenditure (21% higher in SUB, 52% in
SUF, 40% in SUP compared to SU). Although the increase in energy expenditure was
on average twice as high in patients than controls no significant group by
condition interaction effect was found. Overall correlations between
posturography measures, EMG and energy expenditure (r=0.33-0.60) were significant
(p<0.001). We conclude that impaired balance control puts an extra demand on the
energy expenditure during motor activities in stroke patients. This should be
considered when prescribing interventions aimed at reducing physiological strain.
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Langue : ANGLAIS