Search

Objective To verify the relation between spontaneous walking speed (Sfree) and oxygen cost of walking at Sfree (Cwfree) in post-stroke hemiparetic patients and to test the validity of a prediction model to estimate Cwfree based on Sfree. Design We included 26 participants (mean age 65.1 years [SD 15.7]) with mild to moderate disability after stroke who walked at Sfree using mobility aids if necessary for 6 min. The Cwfree was measured at a stabilized metabolic rate by indirect calorimetry with the Metamax 3B spiroergometry device. The relation between Sfree and Cwfree was analyzed by the correlation coefficient (r) and coefficient of determination (R2). The Cwfree prediction model was developed from a regression equation, then tested on a second population of 29 patients (mean age 62.1 years [SD 13.4]) with the same inclusion and exclusion criteria. Results For the 26 participants, the Sfree and Cwfree were highly correlated ( r = −0.94 and R2 = 0.97), which allowed for formulating a regression equation and developing the Cwfree prediction model based on Sfree. The prediction model tests yielded accurate results (mean bias −0.02 mL.kg −1 .m −1 ; 95% limits of agreement −0.31 to 0.26 mL.kg −1 .m −1 ). The relation between Cwfree estimated by the model and measured by Metamax was high (R2 = 0.98). Conclusion Cwfree was strongly correlated with Sfree, which allowed for the development of a valid Cwfree prediction model. A practitioner could estimate the energy expenditure of walking for a patient without using an indirect calorimeter. [ABSTRACT FROM AUTHOR]

To report all equations that can potentially be used to estimate the oxygen cost of walking (Cw) without using a respiratory gas exchange analyzer and to provide the level of reliability of each equation. Webline, Medline, Scopus, ScienceDirect, Bielefeld Academic Search Engine (BASE), and Wiley Online Library databases from 1950 to August 2019 with search terms related to stroke and oxygen cost of walking. This systematic review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the methodological quality of included studies was determined with the Critical Appraisal Skills Programme (CASP). We screened 2065 articles, and 33 were included for full-text analysis. Four articles were included in the data synthesis (stroke individuals = 184). Analysis reported 4 equations estimating Cw that were developed from logistic regression equations between Cw and self-selected walking speed. The equations differed in several methodological aspects (characteristics of individuals, type of equation, Cw reference measurement methods). The Compagnat et al. study had the highest quality (CASP score = 9/9). This literature review highlighted 4 equations for estimating Cw from self-selected walking speed. Compagnat et al. presented the best quality parameters, but this work involved a population restricted to individuals with hemispheric stroke sequelae. [ABSTRACT FROM AUTHOR]

Introduction/Background Pre-frontal cortex (PFC) activity during dual task (DT) condition in stroke patients remains unclear. Functional near-infrared spectroscopy (fNIRS) is a functional neuroimaging technique for studying cortical activity. The purpose of this study was to evaluate the hemodynamic activity of the PFC in two DT conditions in post-stroke patients. Material and method Stroke patients were instructed to perform a cognitive task (n-back test) while continuously walking. They were evaluated in DT low (n-1 back) and high (n-2 back) cognitive load. fNIRS recorded bilateral PFC activity and GAITRite measured gait parameters in these two DT conditions. Cognitive performance was evaluated by the number of answers, the number of correct answers and the error percentage. The main endpoint was the DT cost, and we compared the change in oxygenated hemoglobin (an indicator of the changes in PFC activation) between the DT high and DT low. Results Eleven stroke patients (8 men and 3 women; mean age, 64.2 ± 19.5 years; range, 28–87 years) were included in the study. The DT cost was higher in DT n-2 (82.1% ± 15.6) compared with DT n-1 (61.2% ± 38.6), P = 0.007. There was no decline of spatiotemporal gait parameters with the increasing of cognitive load ( P > 0.05) and no difference for the number of answers in DT high versus low cognitive load ( P > 0.05). The number of correct answers was lower during DT high (3 ± 2.4) versus DT low (7.8 ± 3.6), P = 0.0015; and the error percentage was higher during DT high (62.3 ± 23.2) versus low condition (24.4 ± 12.9), P = 0.0001. Conclusion There was a greater increase bilateral PFC activity during DT high versus DT low. The increasing DT cost allowed to maintain spatiotemporal gait parameters in DT high and led to a degradation of the cognitive performance. During DT, PFC activation might prioritize gait performances in stroke patients when the cognitive load is high. [ABSTRACT FROM AUTHOR]

Introduction/Background The energy cost of walking is a marker of metabolic solicitation and allows energy quantification of walking. It is strongly correlated to the patient's walking speed with post-stroke sequelae. We wanted to develop a model for predicting the energy cost of walking to create of walking distance recommendations aimed at achieving recommended energy expenditure levels to ensure health benefits (> 1000 kcal/week during physical activities). Objective To verify the close relationship between spontaneous walking speed (S free ) and energy cost of walking at S free (Cw free ) in subjects with post-stroke hemiparetic patients sequelea and to test the validity of a prediction model to estimate Cw free based on S free . Material and method Twenty-six mild to moderately disabled chronic participants with stroke aged 65 yrs (± 15.7yrs) walked at S free using mobility aids if necessary, for 6 minutes. The Cw free was measured at a stabilized metabolic rate by indirect calorimetry using the Metamax3B device. The relationship between S free and Cw free was analyzed using the correlation coefficient, coefficient of determination. The Cw free prediction model was developed from a regression equation and then tested on a new population with the same inclusion/exclusion criteria ( n = 29). Results S free and Cw free had a correlation coefficient of −0.94 and a R 2 of 0.97 enabling to formulate a regression equation and develop the Cw free prediction model based on S free . The prediction model tests yielded accurate results with a mean bias of −0.02 mL.kg −1 .m −1 –MD% = 4%. The limits of agreement were −0.31; 0.26 mL.kg −1 .m −1 MD% = 30.9% of the mean measured Cw free . Conclusion Cw free can be estimated precisely by a simple measurement of the walking speed. In this way, we can easily define the distance the subject must travel according to his Cw to reach the recommended energy expenditure targets. It is a great help for the practitioner for recommendations in the field of physical activity after stroke. [ABSTRACT FROM AUTHOR]