Abstract
Physiological Cost Index (PCI) has been proposed to assess gait demand. The purpose of the study was to establish whether PCI is a valid indicator in subacute stroke patients of energy cost of walking in different walking conditions, that is, over ground and on the Gait Trainer (GT) with body weight support (BWS). The study tested if correlations exist between PCI and ECW, indicating validity of the measure and, by implication, validity of PCI. Six patients (patient group (PG)) with subacute stroke and 6 healthy age- and size-matched subjects as control group (CG) performed, in a random sequence in different days, walking tests overground and on the GT with 0, 30, and 50% BWS. There was a good to excellent correlation between PCI and ECW in the observed walking conditions: in PG Pearson correlation was 0.919 (p < 0.001); in CG Pearson correlation was 0.852 (p < 0.001). In conclusion, the high significant correlations between PCI and ECW, in all the observed walking conditions, suggest that PCI is a valid outcome measure in subacute stroke patients.
Highlights
In stroke survivors cardiorespiratory reconditioning represents a challenge to improve patients’ mobility and quality of life, especially for those who regain deambulation in the community [1].The stroke survivor reduction of cardiovascular fitness is a real problem limiting patients’ return in community life
The purpose of the study was to establish whether Physiological Cost Index (PCI) is a valid indicator in subacute stroke patients of energy cost of walking in different walking conditions, that is, over ground and on the Gait Trainer (GT) with body weight support (BWS)
The mean self-selected walking speed of PG during overground walking test (OGWT) was 1.25 ± 0.51 km/h; in the same WT control group (CG) walked at 3.60 ± 0.44 km/h, a speed significantly higher than that chosen by PG (p < 0.001)
Summary
In stroke survivors cardiorespiratory reconditioning represents a challenge to improve patients’ mobility and quality of life, especially for those who regain deambulation in the community [1].The stroke survivor reduction of cardiovascular fitness is a real problem limiting patients’ return in community life. As recommended by the American Heart Association, moderate aerobic training is useful in subacute stroke condition to avoid deconditioning [3], and several authors during the last 10 years documented the importance of an aerobic training in stroke survivors in terms of reducing insulin resistance, improving lipid profile and glucose tolerance, and improving cognitive function [4,5,6] For these reasons electromechanical assisted and robotic machines providing body weight support (BWS) were made to train nonambulatory patients, with less demand for the physiotherapist, and should be useful for increasing the amount of walking exercise avoiding deconditioning. Chang et al demonstrated that more than two weeks of Lokomat training improved cardiovascular fitness early after stroke [7]
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