Article

A higher energy cost of walking poststroke has been linked to reduced
walking performance and reduced participation in the community. OBJECTIVE: To
determine the contribution of postintervention improvements in walking speed and
spatiotemporal gait asymmetry to the reduction in the energy cost of walking
after stroke. METHODS: In all, 42 individuals with chronic hemiparesis (>6 months
poststroke) were recruited to participate in 12 weeks of walking rehabilitation.
The energy cost of walking, walking speed, and step length, swing time, and
stance time asymmetries were calculated pretraining and posttraining. Sequential
regression analyses tested the cross-sectional (ie, pretraining) and longitudinal
(ie, posttraining changes) relationships between the energy cost of walking
versus speed and each measure of asymmetry. RESULTS: Pretraining walking speed
(beta = -.506) and swing time asymmetry (beta = .403) predicted pretraining
energy costs: adj R (2) = 0.713; F(3, 37) = 34.05; P < .001. In contrast, change
in walking speed (beta = .340) and change in step length asymmetry (beta = .934)
predicted change in energy costs with a significant interaction between these
independent predictors: adj R (2) = 0.699; F(4, 31) = 21.326; P < .001.
Moderation by the direction or the magnitude of pretraining asymmetry was not
found. CONCLUSIONS: For persons in the chronic phase of stroke recovery, faster
and more symmetric walking after intervention appears to be more energetically
advantageous than merely walking faster or more symmetrically. This finding has
important functional implications, given the relationship between the energy cost
of walking and community walking participation.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS