Rollator Use Does Not Consistently Change the Metabolic Cost of Walking in People With Chronic Obstructive Pulmonary Disease

Abstract

Hill K, Dolmage TE, Woon LJ, Brooks D, Goldstein RS. Rollator use does not consistently change the metabolic cost of walking in people with chronic obstructive pulmonary disease. ObjectivesTo (1) evaluate whether the use of a rollator changed metabolic cost during a controlled walking task, and (2) explore relationships between the difference in dyspnea and metabolic cost associated with rollator use. DesignSingle-group interventional study in which patients completed 2 corridor walks: 1 without and 1 with a rollator, at the same individualized constant speed. SettingRehabilitation hospital. ParticipantsPatients with chronic obstructive pulmonary disease (N=15; 10 men; median age [interquartile range; IQR]=69 [12]y; forced expiratory volume in 1 second=42 [20]% predicted). InterventionRollator use. Main Outcome MeasuresOxygen uptake, converted to metabolic equivalent units (METs), and minute ventilation were measured throughout both tasks using a portable gas analysis system; dyspnea and arterial oxygen saturation (SpO2) were collected on completion. ResultsMedian [IQR] walk speed [IQR] was 48 (10)m/min. Walking with a rollator, compared with walking without, reduced dyspnea (median [IQR]=1.0 [1.5] vs 2.0 [2.0]; P=.01) without changing energy expenditure (median [IQR]=2.8 [1.2] vs 3.2 [0.9] METs; P=.65), minute ventilation (median [IQR]=30.3 [9.6] vs 27.7 [9.9]L/min; P=.50), or SpO2 (median [IQR]=92 [8]% vs 94 [10]%; P=.41). The association between the reduction in dyspnea and any difference in energy expenditure related to rollator use was of borderline significance (rs=.50; P=.06). Six of the 8 participants who experienced a reduction in dyspnea also demonstrated a reduction in the metabolic cost of walking. ConclusionsThe mechanism responsible for the amelioration in dyspnea during rollator-assisted walking is multifactorial. A reduction in the metabolic cost of walking may play a part in some, but not all, patients.