Abstract WP317: High Metabolic Cost of Mobility and Balance Activities in Individuals Post-Stroke

Abstract

Purpose: Metabolic cost of walking at a comfortable speed for individuals post-stroke is higher than for healthy individuals. However, metabolic cost of other activities, relevant for community activity, such as transfer from sitting to standing and walking over obstacles, has not been reported. Hence, the aim of this study was to measure metabolic cost of mobility and balance activities for individuals post-stroke, and to assess the hypothesis that it will be higher than for healthy individuals. Methods: Eleven post-stroke (7 men, age 49.5±12.2), and 8 healthy (3 men, age 46.8±6.7) individuals of comparable height and weight participated in the study. Gait speed was measured and motor impairment was evaluated using the Fugl-Meyer test. Four activities were tested for their metabolic cost; walking at a comfortable speed, walking over an obstacle course, sit to walk and standing on balance foam while reaching forward. Each activity was performed repeatedly for 8 minutes, while metabolic measures were recorded. In addition, distance covered, or number of repetitions completed, during the activity were recorded. Metabolic cost of each activity was calculated by dividing the mean oxygen consumption of the last four minutes of the activity by the number of repetitions or walking speed. Results: The Fugl-Meyer scores for post-stroke individuals for lower and upper extremities were 23.6±6.5 and 43.6±19.3 respectively. Comfortable gait speed was 0.8±0.3 m/sec. for post-stroke and 1.4±0.1 m/sec. for healthy individuals. Groups were not significantly different in weight and height. Metabolic cost and between-group comparisons are shown in the table. Conclusion: The metabolic cost of the activities was significantly higher for individuals post stroke than for healthy, suggesting that rehabilitation programs should aim to improve economy of movement.