Saturday, May 09, 2015

Musing: Physiological Responses and Energy Cost of Walking on the Gait Trainer With and Without Body Weight Support in Subacute Stroke Patients

Dean Reinke
Deans’ Stroke Musing
Friday, April 18, 2014

No clue but I'm sure your therapist is all over this - Physiological Responses and...

Anna Sofia Delussu*, Giovanni Morone, Marco Iosa, Maura Bragoni, Marco Traballesi and Stefano Paolucci
* Corresponding author: Anna S Delussu s.delussu@hsantalucia.it

Author Affiliations

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Journal of NeuroEngineering and Rehabilitation 2014, 11:54  doi:10.1186/1743-0003-11-54
Published: 10 April 2014

Abstract


Background

Robotic-assisted walking after stroke provides intensive task-oriented training. But, despite the growing diffusion of robotic devices little information is available about cardiorespiratory and metabolic responses during electromechanically-assisted repetitive walking exercise. Aim of the study was to determine whether use of an end-effector gait training (GT) machine with body weight support (BWS) would affect physiological responses and energy cost of walking (ECW) in subacute post-stroke hemiplegic patients.

Methods

Participants: six patients (patient group: PG) with hemiplegia due to stroke (age: 66 ± 15y; time since stroke: 8 ± 3 weeks; four men) and 6 healthy subjects as control group (CG: age, 76 ± 7y; six men).

Interventions

Overground walking test (OWT) and GT-assisted walking with 0%, 30% and 50% BWS (GT-BWS0%, 30% and 50%). Main Outcome Measures: heart rate (HR), pulmonary ventilation, oxygen consumption, respiratory exchange ratio (RER) and ECW.

Results

Intervention conditions significantly affected parameter values in steady state (HR: p = 0.005, V’E: p = 0.001, V'O2: p < 0.001) and the interaction condition per group affected ECW (p = 0.002). For PG, the most energy (V’O2 and ECW) demanding conditions were OWT and GT-BWS0%. On the contrary, for CG the least demanding condition was OWT. On the GT, increasing BWS produced a decrease in energy and cardiac demand in both groups.

Conclusions

In PG, GT-BWS walking resulted in less cardiometabolic demand than overground walking. This suggests that GT-BWS walking training might be safer than overground walking training in subacute stroke patients.



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